                                ORDER FORM FOR

                     SUPER CHASE - arcade style game v 1.0

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Date (DD-MM-YYYY): __ __ ____        
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Name:     ______________________________________ | Comments & suggestions:
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Street:   ______________________________________ | ________________________
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City:     ______________________________________ | ________________________
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Country:  ______________________________________ | ________________________
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Post/zip code: _________________________________ | ________________________
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Phone nymber: ___________________________________| ________________________
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FAX number _____________________________________ | ________________________
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E-Mail:   ______________________________________ | ________________________

Computer used (no idea why I want to know this) _____________________


Please send me game on this type of diskette:

5"1/4:  1.2MB [ ]       3"1/2: 1.44MB [ ]

Type of registration:
Reg.fee     Products

  $10  [ ]  Full version of Superchase v1.0 with 7 levels.
  $5   [ ]  Turbo pascal unit which is used on this game with source code
            (includes playflic, blowfigure, boom effects, sound_fx, 
             sound setup...)
  $10  [ ]  Graphics editor in which was created this game allow you 
            to do frames and simple pictures.

Important note:
 In these kinds of registration, please accept more or less amount which
 covers the extra postage depending of postage rates to country in which 
 you live. (It should be less than $3 dolars).

Method of payment:
 [ ] cash                   
 [ ] transfer to account, 
     account number is: 2216130006/1100 , bank swift code: TATR SK BX
 

Fast contact
(way how to contant you with latest information and versions): via
 [ ] mail                   [ ] e-mail

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 All the prices are in US Dollars but I accept these other currencies too:
 FIM, DKK, DEM, CAD, ATS, CHF, SEK, GBP according to current exchange 
 rate. 

 Print a file regform.txt, fill it in and send to the following address 
 along with the fee or the acknowledge of the bank transfer:

 name     : Igor Kracun
 street   : Na graniari 1
 city     : Banska Bystrica
 ZIP      : 97401       
 country  : Slovakia (SK)



                        THANK YOU!!!
