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REGISTRATION FORM
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If you want to register by telephone, fax, or check, use this form.

To: Register Now!
ATTN Orders
PO Box 1816
Issaquah, WA 98027
United States of America

Telephone 
Toll Free: 877-353-7297
Regular: 425-392-2294 

Fax 
Toll Free: 888-353-7276
Regular: 425-392-0223

ORDER INFORMATION
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Product Name	: JongPuzzle (ID 4491-2)
Price		: US$ 11.95
Quantity   	:

Mail or fax orders, please add US$ 2.50 each order.
Telephone orders, please add US$ 3.00 each order.

Total		: US$

PERSONAL INFORMATION
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First Name	:
Last Name	:
Company		:
Billing Address	:

City		:
State/Province	:
Zip/Postal Code	:
Country		:
Phone		:
*Email Address	:

PAYMENT INFORMATION
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[ ] Check (made payable to Register Now!)
[ ] Visa
[ ] MasterCard
[ ] American Express
[ ] Discover (Novus)

Name on Card	:
Card Number	:
Expiration Date	:


* Email address is REQUIRED. We will send you the registration code via email.