ImagiSOFT, Inc. CHINESE CHECKERS REGISTRATION FORM Quantity Description Price Total ------------------------------------------------------------- | | Chinese Checkers | $14.95 | | ------------------------------------------------------------- | | Shipping Outside USA | 3.00 | | ------------------------------------------------------------- | | Sales Tax (NM Residents only) | .86 | | ------------------------------------------------------------- TOTAL AMOUNT ENCLOSED | | ----------- Make checks payable to ImagiSOFT, Inc. Personal checks must be drawn on a US bank. If ordering outside the United States, please use a credit card. Disk Size: ___ 5.25" ___ 3.5" [ ] Check [ ] VISA [ ] Master Card [ ] American Express Card Number: _____ _____ _____ _____ Exp. Date: _______ Signature: _________________________________________________ (credit card orders must be signed) Name: _______________________________________________________ Address: ____________________________________________________ City: _______________________________________________________ State / Country: ____________________________________________ Zip / Postal Code: __________________________________________ I received Chinese Checkers from: [ ] friend [ ] disk vendor [ ] user group [ ] free BBS [ ] pay BBS [ ] other Name of vendor, BBS, etc. ___________________________________ Comments, suggestions: Mail to: ImagiSOFT, Inc. Computer Games Division P.O. Box 13208 Albuquerque, NM USA 87192