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Text File  |  1995-03-07  |  1KB  |  46 lines
  1. PMFB v2.1 - Order Form
  2.  
  3. You can send this order form via fax, e-mail or U.S. mail.
  4.  
  5. TO:
  6.  
  7. PlayMaker, Inc.
  8. 19 Overshot Court
  9. Phoenix, MD 21131-1851
  10. Internet: playmaker@aol.com
  11. Fax: 410/667-8429
  12.  
  13. FROM: 
  14.  
  15. E-Mail Address/Screen Name:                                      
  16.  
  17. Name:                                                            
  18.  
  19. Street:                                                          
  20.  
  21. Suite/Apt. #:                                                    
  22.  
  23. City/Province:                                                   
  24.                                                                         
  25. State:                         Zip/Postal Code:                  
  26.  
  27. Country:                            
  28.  
  29. Telephone #:                                                     
  30.  
  31. Visa or M/C #:                                                                 
  32.  
  33. Exp Date:                                        
  34.  
  35. Name on the Card:                                                
  36.  
  37. PERSONAL ID: _______________________
  38. (The full game installer will provide you with a personal ID code which we need to properly register you and provide you with the correct authorization keycode. You need to type in your name to change the AAAAAAAA to your own personal code.)
  39.  
  40. Where Installer Was Found:                                       
  41.  
  42. FOR:
  43.  
  44. PlayMaker Football™ v2.1
  45. $20.00 U.S.
  46.