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		      RAY'S NUMBERS GAME v1.0 ORDER FORM
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     	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 			  12 - 00   [ ]
     	Site license for use on up to 6 machines	  30 - 00   [ ]
	Site license for use on more than 6 machines	  45 - 00   [ ]
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	Purchasers name and address:

	Name   .................................

	Address ................................

		................................	

		................................

	Email(if available)  .....................................
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	Do you wish to receive registration by:  Email [  ]	Post [  ]
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	Please send this form, together with your payment to:

	R. Le Couteur
	47 Daffodil Way      Cheques/PO's payable to: R. LE COUTEUR
	Chelmsford				
	Essex
	CM1 6XB		Email: RayLec@compuserve.com
			Tel:   01245 466078
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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 licence  and that the licensed copy
	will not be made available to any third parties.
	  	
    		Purchaser's Printed Name:  .............................
    	
  	        Signature: ...........................
 