Realmz Registration / Order Form (Win Version)

Mail this completed form with payment to:
Fantasoft, LLC
P.O. Box 14261
Madison, WI 53714-0261
USA

To order by phone, call us at (608) 222-8468.
To order by Fax call (608) 222-8468
To order by E-Mail, send the information below to:
Fantasoft1@aol.com or order online using our secure web site at:
http://www.fantasoft.com/orders.html

SERIAL NUMBER OF YOUR COPY OF REALMZ P-___________Version_________

To find the serial number and version of your copy, select "About Realmz"
under the INFO menu.  The serial number and version will be displayed in
the upper left hand corner.

Last Name___________________ First Name _________________
Address__________________________________________________
_________________________________________________________
_________________________________________________________
City ____________________  State/Province _______________
Zip/Postal____________________  Country _________________
Phone:___________________E-Mail:_________________________
I would like to register:
"Realmz" scenario driver and "City Of Bywater".Yes____$20
"Prelude To Pestilence" scenario.....FREE W/ $13 Purchase
"Assault On Giant Mountain" scenario...........Yes____$13
"Castle In The Clouds" scenario................Yes____$13
"Destroy The Necronomicon" scenario............Yes____$13
"White Dragon" scenario........................Yes____$13
"Griloch's Revenge" scenario...................Yes____$13
"Trouble in the Sword Lands" scenario..........Yes____$13
"War in the Sword Lands" scenario..............Yes____$13
"Mithril Vault" scenario.......................Yes____$13
"Twin Sands of Time" scenario..................Yes____$13
"Half Truth" scenario..........................Yes____$13
_________________________________________________________

I Would like to order by mail:
Character Editor Mailed Anywhere in North America..____$10
Character Editor Mailed Outside North America......____$13

				      Total Due = $____
          
Method of Payment: [  ] Cash - Check - Money Order
		   [  ] Visa / Mastercard / Am-Ex / Discover

___________________________________________________________________
Account Number				Expiration Date
___________________________________________________________________
Name exactly as it appears on the credit card