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Text File  |  1991-09-03  |  2KB  |  60 lines
  1.  
  2.  
  3.                                  ImagiSOFT, Inc.
  4.  
  5.                       CHINESE CHECKERS REGISTRATION FORM
  6.  
  7.  
  8.          Quantity   Description                   Price       Total
  9.          -------------------------------------------------------------
  10.          |      | Chinese Checkers              |  $14.95  |         |
  11.          -------------------------------------------------------------
  12.          |      | Shipping Outside USA          |    3.00  |         |
  13.          -------------------------------------------------------------
  14.          |      | Sales Tax (NM Residents only) |     .86  |         |
  15.          -------------------------------------------------------------
  16.                                      TOTAL AMOUNT ENCLOSED |         |
  17.                                                            -----------
  18.          Make checks payable to ImagiSOFT, Inc.
  19.          Personal  checks  must be drawn on a US  bank.   If  ordering
  20.          outside the United States, please use a credit card.
  21.  
  22.          Disk Size:  ___ 5.25"  ___ 3.5"
  23.  
  24.          [ ] Check   [ ] VISA   [ ] Master Card   [ ] American Express
  25.  
  26.          Card Number:  _____ _____ _____ _____     Exp. Date:  _______
  27.  
  28.  
  29.          Signature:  _________________________________________________
  30.                         (credit card orders must be signed)
  31.  
  32.          Name: _______________________________________________________
  33.  
  34.          Address: ____________________________________________________
  35.  
  36.          City: _______________________________________________________
  37.  
  38.          State / Country: ____________________________________________
  39.  
  40.          Zip / Postal Code: __________________________________________
  41.  
  42.  
  43.          I received Chinese Checkers from:
  44.            [ ] friend          [ ] disk vendor      [ ] user group
  45.            [ ] free BBS        [ ] pay BBS          [ ] other
  46.  
  47.          Name of vendor, BBS, etc. ___________________________________
  48.  
  49.          Comments, suggestions:
  50.  
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  54.  
  55.                   Mail to:            ImagiSOFT, Inc.
  56.                                       Computer Games Division
  57.                                       P.O. Box 13208
  58.                                       Albuquerque, NM   USA   87192
  59.  
  60.