Fax Order Form


Product Name _________________________________________________

Product Number _________________________________________________




First Name_______________________________________________________

Last Name________________________________________________________

Address    ______________________________________________________

City_____________________________State/Province__________________

Zip Code/Postal Code___________________Country__________________


E-Mail address_________________________________________________
                     (for quick receipt of registration code- please print clearly)

Phone__________________________________________________________


Order information:

Quantity______

Payment Information

Name of Card____________________________________________________

Type of Card: Visa___ Mastercard____  American Express____ Discover (Novus)_____

Card Number_____________________________________________________

Expiration Date:   Month_____   Year (4 digits)_____



*********** Additional Help Information **************

Net Gin Rummy $19.95, product number 1580-27
Net Cribbage $19.95, product number 1580-19
Net Spite and Malice $19.95, product number 1580-21
Net Poker $14.00, product number 1580-23
Net Spades $14.00, product number 1580-22
Net Durak $14.00, product number 1580-18
Net Chess $14.95, product number 1580-25
Net Checkers $14.95, product number 1580-24
Net Sea War $14.00, product number 1580-17