ORDER FORM           Prices subject to change without notice.

 TO:                                   Date: ____________________
             Simon Avery
             Hamlyn's Cottage
             Old Exeter Road
	     Chudleigh
	     South Devon
	     TQ13 0DX
	     ENGLAND
	     UK
 FROM:
       Name: ____________________________________________________

  [Company]: ____________________________________________________

    Address: ____________________________________________________

       City: ____________________________________________________

     County: _______________________Post/Zip Code: ______________

    Country: ___________________________ Phone: _________________
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 INDIVIDUAL License for the use of "Gerbil Riot of '67"
 for MS-DOS:   1 registration at œ3.00 (pounds sterling) (tick here) _____

 We will ship you the latest version upon receipt of your order.
 (Overseas orders please add œ2.00 sterling for postage.)

 Diskette format (choose one)    5.25" disk ___   3.5" disk ___

For internal site licenses, please enquire.
 ========================================================================

 TOTAL PRODUCTS                                                    ______

 Overseas orders (Non-UK residents) please add œ2.00 (sterling)    ______

 TOTAL ORDER                                                       ______

                                                  TOTAL ENCLOSED   ______
 Payment method: ( ) Cheque    ( ) Cash     ( ) Postal Order
			       ( ) Money Order


 TITLE: __"Gerbil Riot of '67" for MS-DOS___________  DATE: _______________