Gameport Secure Ordering Form

This form is for ordering by mail.
Please complete and print this form and send it together with a check to the address below:
MS Electronics - Gameport
10661 Rene St.
Lenexa, KS 66215

Product Description

Product:		Yendorian Tales Book 1 Chapter 1
Platform:		PCGames
Price:		US $27.00 -- includes UPS shipping
Currently we are only shipping this game to the U.S. and Canada

Personal Information

First Name:
Middle Initial:
Last Name:
Street Address:
Apt/Suite #:
City:
State (U.S. only):
Zip/Postal Code:
Work Phone:	US and Canada xxx-xxx-xxxx
Home Phone:	US and Canada xxx-xxx-xxxx
E-mail Address:

Register Software

Upon credit card approval, your credit card will be charged the amount of US $27.00, and your order will be processed and details of this purchase will be sent promptly to the E-mail address above.

Please make sure that your E-mail address is correct!

Your product will be shipped to you in the next few days.