ORDER FORM FOR PROTEC --------------------- You can send this order form to: Wilfried Lottermoser Spechtweg 7 66287 Quierschied Germany I would like to order the game PROTEC for IBM-compatible PCs for the price of 29 German Marks (DM) plus shipping costs. Shipping costs: =============== Inside Germany (Cheque/Cash/Remittance) 1 DM European foreign countries: 3 DM Cheque/Cash/Remittance in German Marks Non-European foreign countries: 6 DM Cheque/Cash/Remittance in German Marks I am paying: __ |__| by Cash Collect (additional 6 German Marks in Germany, 9 German Marks in rest of Europe) __ |__| by Enclosed Cheque or Cash __ |__| by Remittance to the Account No. 210-035.309 BLZ 590 501 01 at the Sparkasse Saarbruecken (only advanced payment) (intended use "Protec" and your name + address) Diskette format: __ |__| 3 1/2 inch diskette __ |__| 5 1/4 inch diskette My address: Name First: _________________ Last: _______________________________ Street: ________________________________________________________ ZIP: ___________ City: _____________________ State: _______ Phone: ________________________ Fax: _________________________ Date: _________________ Signature: __________________________