03/25/95 (SDN) REGISTRATION / ORDER FORM (OJB) ============================================================================ PLEASE MARK YOUR GAME SELECTION(S): PLEASE MARK DISK TYPE: Ultimate Blackjack ______ Ultimate Gin _____ Disk Type: Ultimate Baccarat ______ Ultimate Poker _____ 1.44 (3.5") _____ Ultimate Craps ______ Ultimate Roulette _____ 1.20 (5.25") _____ Digital Downs ______ Operation "Just Because" _____ VALUE GROUPS: Choose from the games listed above, mark selection(s) above. One game ---------------------------- $13.00 ---------- $_____.____ Two games --------------------------- $21.00 ---------- $_____.____ Three games ------------------------- $29.00 ---------- $_____.____ Four games -------------------------- $37.00 ---------- $_____.____ Five games -------------------------- $45.00 ---------- $_____.____ Six games --------------------------- $53.00 ---------- $_____.____ All games --------------------------- $60.00 ---------- $_____.____ Sound Blaster Sound Pack(s) --------- $ 5.00 ---------- $_____.____ (Sound Blaster or 100% compatible card required; buy one sound pack, get the rest free). WINDOWS PROGRAMS AVAILABLE: Image Master PLUS -------------------- $22.95 ---------- $_____.____ SUBTOTAL $_____.____ TAXES: California residents add sales tax of 7.75%. (multiply subtotal by .0775) ---------- $_____.____ SHIPPING: The above prices include shipping charges. C.O.D. available add $3.50 ------ $_____.____ Foreign orders (except Canada) add $2.00 ------- $_____.____ TOTAL $_____.____ Check the game(s) of your choice, fill out the order form, enclose your check, or M.O. payable to Accidental Software, or send your charge card information. FOREIGN ORDERS: Specify U.S. funds. (CRAPS) Your Name:____________________________ Mail to...... ACCIDENTAL SOFTWARE Address:____________________________ 13245 SKIOMAH RD. APPLE VALLEY, CA. 92308 Address:____________________________ Phone Orders 1-800-771-6746 City,State,Zip:____________________________ or 1-619-247-2804 FAX 1-619-247-6819 __ VISA or MasterCard number __________________________ |__| VISA Expiration date ____________________________________ __ |__| MasterCard Card holders signature _____________________________ Phone orders 8AM to 5PM Pacific Standard Time, Monday through Friday. FAX 1-619-247-6819, 24 hours. ============================================================================ Shareware Survey: How did this product come to your attention? ___ 1. From a shareware vendor (name) __________________________________. ___ 2. From a BBS (name) _______________________________________________. ___ 3. From a friend. ___ 4. Other (please specify) __________________________________________.