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 |                   Simple Pleasures 1.13 Registration Form                  |
 |============================================================================|
 |                                                                            |
 |       Your Name: _________________________________________________________ |
 | Mailing Address: _________________________________________________________ |
 |                  _________________________________________________________ |
 |                  _________________________________________________________ |
 |                  _________________________________________________________ |
 |    Phone Number: ________________________ FAX: ___________________________ |
 |  E-Mail Address: _________________________________________________________ |
 |                                                                            |
 |  Comments: _______________________________________________________________ |
 |            _______________________________________________________________ |
 |            _______________________________________________________________ |
 |                                                                            |
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 | Name Of Game                                           Price               |
 |----------------------------------------------------------------------------|
 | Simple Pleasures .................................... $15.00 ..... _______ |
 | Solitaire Suite ..................................... $15.00 ..... _______ |
 | Pyramid Deluxe ...................................... $15.00 ..... _______ |
 | Four Seasons for Windows ............................ $10.00 ..... _______ |
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 | Discount Schedule (Games Ordered: $Discount)    |       Sub Total: _______ |
 |    2 Games: $5    3 Games: $10    4 Games: $15  |  Minus Discount -_______ |
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 | Shipping & Handling (Free in North America, $5.00 Otherwise) ..... _______ |
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 |                                                     Total Payment: _______ |
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 |                                                                            |
 | Method Of Payment:  ___ Cash         ___ Check (#_____)   ___ Money Order  |
 |                     ___ Mastercard   ___ VISA             ___ Discover     |
 |                                                                            |
 |  Credit Card Info:  Account Number: ______________________________________ |
 |                    Expiration Date: ____ / ____                            |
 |       Exact Name Appearing On Card: ______________________________________ |
 |                          Signature: ______________________________________ |
 |                                                                            |
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 |                                                                            |
 |    Mail This Form To: Randy Rasa                (cash, check, money order  |
 |                       18215 Troost                         or credit card) |
 |                       Olathe, KS 66062-9208                                |
 |                                                                            |
 |     FAX This Form To: 816-746-9991              (credit card orders only!) |
 |                                                                            |
 |  E-Mail This Form To: rasa.software@dden.com    (credit card orders only!) |
 |                                                                            |
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 |Prices and terms are subject to change without notice.  Orders that do not  |
 |include all relevant information cannot be processed.  Orders will be proc- |
 |essed within two weeks of receipt of order.  Checks must be drawn on a U.S. |
 |bank, and payable in U.S. funds.  Credit card charges will appear on your   |
 |statement as "D.O.C.S." If no disk size is specified, 1.44M will be assumed.|
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