ORDER FORM FOR ATLANTIS SOFTWARE Send order form to: Jimmy Rose 2000 Linden Ave. Middletown, OH 45044-4435 USA All orders are processed promptly. Be sure you put a checkmark by the program(s) you're ordering. See the list at the bottom of this form. IMPORTANT! Be sure to fill in the name field below with the name you want the program to be registered to. Your registration number will only work for this name. >>> Make Check or Money Order payable to: Jimmy Rose <<< Canadian orders must send a Canadian Postal Money Order in US$ Foriegn orders must send an International Money Order in US$ ORDER FORM ============================================================================ PLEASE TYPE OR PRINT CLEARLY Name:_____________________________________________________ Company:__________________________________________________ Street address:___________________________________________ City/State:___________________________ ZIP code:__________ Country:__________________________________________________ Current version of this program that you are presently using: __________________________________________________________ The following information is optional Phone:________________________ FAX:_______________________ Age:_____________ Occupation:_____________________________ Following are network addresses for various networks, If you have an address for a network please enter it: FidoNet:__________________________________________________ InterNet:_________________________________________________ ** If you operate a BBS, fill out the next fields: BBS Name:________________________________________________ BBS Software:____________________________________________ BBS phone number(s): _________________________________________________________ Please tell us where you discovered this program: ________________________________________________________ Please insert any comments about this program: _________________________________________________________ _________________________________________________________ _________________________________________________________ ============================================================================= PLEASE CHECK THE APPROPRIATE BOX Program Price [ ] The Guest Registry $20.00 [ ] The Personals $20.00 [ ] Election Day! $15.00 [ ] The Wall of Wisdom $15.00 [ ] Softball Manager $15.00 ----------------------------------------------------------------------------- Shipping & Handling Fee [ ] Send Disk with latest version of Atlantis $3.00 Programs & other shareware programs. [ ] Send registration code to my FidoNet address. $0.00 (Free) (Be sure to include your proper address above). [ ] Send registration Code to my Internet address $0.00 (Free) (Be sure to include proper address above) [ ] Send registration code via U.S. Mail $0.00 (Free) Price includes free upgrades for DOS based BBS doors. You should check The Prophecy BBS every 4-6 months for updates. =============================================================================