ORDER FORM
GO-LOTTO V4.xx REGISTRATION $29.95 USD
NAME________________________________________________
ADDRESS_____________________________________________
ADDRESS_____________________________________________
CREDIT CARD #_______________________________________
Visa,MC,Discover, or American Express
3 DIGIT SECURITY CODE______________________________
EXPIRE DATE_________________________________________
TELEPHONE #_________________________________________
SIGNATURE ___________________________________________
For quicker registration and no shipping and handling charge,
also add E-MAIL address and registration number will be
sent by E-MAIL to you.
E-MAIL ADDRESS
____________________________________________
Make check or money order payable to O'Falls Software
(allow 3-4 weeks for Delivery on Personal Checks).
O'FALLS SOFTWARE
631 OLD PLANTATION ROAD
JEKYLL ISLAND GA 31527