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	      RAY'S NUMBERS GAME v2.0 ORDER FORM - CREDIT CARDS ONLY
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			Product Number: 15280
     	Please complete all sections of this form  in full in order to
     	process  your  order.  YOU MUST OBTAIN  THE APPROPRIATE LICENCE
     	FOR YOUR USE.
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	What type of licence do you require?  Please tick one box. 
 
     	For use on a SINGLE computer 			  $20 - 00  [ ]
     	Site license for up to 6 machines	          $50 - 00  [ ]
	Site license for more than 6 machines	          $75 - 00  [ ]
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	Purchasers Details:

	I wish to pay by: Mastercard[ ]   Visa[ ]   Amex[ ]  Discover[ ] 

 	Name exactly as on card: ___________________________________

 	Card Number:_____________________________ Expiry Date___________

 	Authorized Signature:  ______________________________________

	Delivery Address ________________________________

			 ________________________________	
		
			 ________________________________
	
	Email(if available)  ____________________________________

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	Do you wish to receive registration by:  Email [  ]	Post [  ]
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	Either FAX this form to PsL at 713-524-6398 or mail it to them at 
	P.O.Box 35705, Houston, Texas 77235-5705, USA
	
	The PsL address/numbers are for ORDERS only. Address ANY queries 
	regarding Ray's Numbers Game to the author.
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    	I understand that Ray's Numbers Game is provided AS IS and without
	warranty of any kind, either express or implied. 
	I confirm that it will be used according to the license.