THE ESCAPE FROM TARABITHIA, REGISTRATION FORM

COMPLEAT THE BLANKS AND MAIL TO THE ADDRESS BELOW


FIRST NAME ____________________

LAST NAME ____________________

STREET ADDRESS ____________________

APARTMENT # ____________________

CITY ____________________

STATE/PROVINCE ____________________

ZIP CODE/POSTAL CODE ____________________

COUNTRY ____________________

PHONE NUMBER  _______________

DATA PHONE NUMBER ____________________

EMAIL ADDRESS ____________________

NAME OF GAME ____________________

SEX (M/F) ____________________

AGE ____________________

SIGNATURE ____________________

Now please tell me where you acquired the game.
Please check all that apply.

1. I saw it advertised in a shareware catalog __________

2. I saw it in the disk files of a Pc-User group __________

3. I downloaded it from a computer bulletin board system_________

4. I received it from a friend __________

 5. I found it on the Internet __________

COMMENTS OR SUGGESTIONS _________________________________________

_________________________________________________________________

PRINT AND MAIL THIS FORM ONLY TO.

Jason billard
P.O. Box 288
Burgeo Newfoundland Canada
A0M 1A0


THANKS FOR PLAYING!!!