AMOEBA WARE REGISTRATION FORM
                               Order Form


              Your Name _________________________________________


              Address   _________________________________________


              City/State Zip  ___________________________________


              Your Voice Phone Number  __________________________


              Your BBS Name   ___________________________________
                             be exact - must match registration #

              Your BBS Number ___________________________________


              Computer Type   ___________________________________


              BBS SOFTWARE    ___________________________________


                      Are you running Multi Node?  ______


             Modem Type (Make/Baud,etc)  ________________________


                     Where did you here about AMOEBA WARE ?

              ____________________________________________________


check one:
            ____  The ON-LINE Catalog  ............... $65.00  (sales door)

            ____  Nuclear Strike v4.1  ............... $25.00  (game)
            ____  Klondike Solitaire v4.0 ............ $25.00  (game)
            ____  Kuwaiti Oil v3.0 ....................$25.00  (game)
            ____  Mindbender! v1.0 ....................$25.00  (game)
            ____  Amoeba Bingo! v1.0 ..................$25.00  (game)

            ____  Game Pack (all 5 games only).........$100.00
            ____  Discount Package (all 6).............$150.00

               Please enclose a check or money order and send to:
                                ANDREW BROWN 
                            #8A Providence Drive
                              Smyrna, DE. 19977