Order Form for Landmark Solutions

Your system is a 386SX or faster with 
VGA graphics, hard disk, and 640Kb memory, Yes_______  No_______
Note:If you checked No, the game will not work with the system

Name:   _____________________________________________________
                             
Address:_____________________________________________________
     
        _____________________________________________________

City:   _____________________________________________________

State:  _________________ Zip:_______________________________
Phone 
Number:  ( ______ ) ________ - ____________

Disk Size   3.5"________  5.25"__________
        
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                                   Quantity             Total  
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Sir AddaLot's Math Adventure       ________ X $19.95 = ________

                         IN residents add 5% Sales Tax ________

                                                 TOTAL ________

Method of payment:      
[ ] Check or money order made payable to Landmark Solutions, Inc.
[ ] VISA     [ ] MasterCard    
     
Card No:__________________________________ Expires:______________
     
Thank You For Registering!!