REGISTRATION / ORDER FORM (Baccarat SW) 04/22/94 ============================================================================ Check one..... (Ultimate Baccarat SW-3.3) Check one..... (Prices shown include $3.00 for shipping and handling, foreign orders other than CANADA must add an additional $2.00 for postage) ___ Baccarat ------------------------------- ($13.00) Disk type..... ___ Baccarat + Voice pack ------------------ ($18.00) ___ Baccarat + Blackjack ------------------- ($21.00) ___ 720K (3.50 DD) ___ Baccarat + Blackjack + Voice packs ----- ($26.00) ___ Baccarat + Gin ------------------------- ($21.00) ___ 1.44 (3.50 HD) ___ Baccarat + Gin + Voice packs ----------- ($26.00) ___ Baccarat + Blackjack + Gin ------------- ($29.00) ___ 1.20 (5.25 HD) ___ Baccarat + Blackjack + Gin + Voice packs ($34.00) Software Total $________ Ca. Sales tax @ 7.75% $________ (California only) Grand Total $________ Send check or money order Your Name:_________________________ to...... ACCIDENTAL SOFTWARE Address:_________________________ 13245 SKIOMAH RD. APPLE VALLEY, CA. 92308 Address:_________________________ Phone Orders (619) 247-2804 City,State,Zip:_________________________ FOREIGN ORDERS: Send International money order (U.S. currency) or check drawn on a U.S. bank or MasterCard / VISA information. For your convenience, we accept MasterCard or Visa. You may charge the amount of your purchase. If you decide to charge, send this sheet to ACCIDENTAL SOFTWARE with the following information or call 619-247-2804. Fax is available if you call first to alert us of the incoming FAX. Check one.... __ VISA or MasterCard number __________________________ |__| VISA Expiration date ____________________________________ __ |__| MasterCard Card holders name __________________________________ Signature __________________________________________ Phone orders accepted between 8AM and 8PM Pacific Standard Time, Monday through Friday. (619) 247-2804 Orders are shipped via U.S. mail. (Ultimate Baccarat 3.3) ============================================================================ 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) __________________________________________. ---------------------------------------------------------------------------- SUGGESTIONS or GAMES YOU WOULD LIKE TO SEE?