Snail Mail Order Form for Berrie Bloem's Mah Jongg - The REAL Game!(TM)

Notes
Sending a cheque straight to the author:
You can register for this program using any of the following payment methods and sending it off to me:
* Bank cheque (US or UK)
* Eurocheque (for UK Sterling Pounds)
* International Money Order (post office or bank)
* Cash (at your own risk)

Please return this form, together with your US check or UK cheque for the appropriate amount for your order, made payable to BLOEM, to the following address:

Bloem
The Coach House Herdmanston
Pencaitland, EH34 5DU
Scotland, United Kingdom

Here are my details: (please print)

Date	..........................................................................
Name	..........................................................................
Address	..........................................................................
Address	..........................................................................
Address	..........................................................................
City	..........................................................................
Postal Code	..........................................................................
State	..........................................................................
Country	..........................................................................
E-Mail Address (optional)	..........................................................................
Tel number (optional)	..........................................................................
Fax Number (optional)	..........................................................................

I would like to receive (please circle option required and indicate the quantity you require):

Product Option	Currency					Quantity Required
Registration Number via email	US $29.95	UK £20.00				...

Total payment enclosed:	.......................................................................................
I found out about Berrie Bloem's Mah Jongg game in/on (optional):	.......................................................................................
	.......................................................................................
	.......................................................................................
Signed:	.......................................................................................