                Box World ( 100 levels ) Order Form
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       Name: _____________________Rodrigo Zogbi Kalil______________________      City: Sorocaba___________________________ State: ______SP_________
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    Country: ____________Brazil___________ Post/Zip Code: _18060-390__________

Where did you obtain
    the program from:  _________________My friend
















































































































































































































































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Payments:
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Payments must be in US Dollars.

   Box World (100 Levels)....   $5.00 x ____ copies  = $___0____
   Overseas shipping.........                 $3.00  + $__0_____
   Total.....................                          $__0_____

specify your disk size:
                          ____ 5.25" ____ 3.5"

Make your check payable to Jeng Long Jiang, and send it to:

     P.O. Box 51731
     2085 E. Bayshore Road
     Palo Alto, CA 94303-9991
     USA
