                  PLBM PalmOS Games Order Form      July 26, 2000
                  ============================
          P.O. Box 10342, Costa Mesa, CA  92627  (USA)  Dept 1264
         Internet: sales@plbm.com or http://www.plbm.com


Ship To:_______________________________ (Name)

        _______________________________ (Address)

        _______________________________ (Include Zip)

Phone:(_____)__________________ Email:_________________________

I am paying by:  [___Check]  [___Money Order]  [___Credit Card]

Credit Card Type:  [___Visa]  [___M/C]  [___Discovr]  [___AMEX]

Number: _________-__________-_________-_________ Exp:____/_____

Cardholder Signature:  ________________________________________

   *** All orders shipped VIA EMAIL - WE NEED YOUR EMAIL! ***

+==============================================================+
|Product Name/Description               |  Price  | Serial #   |
|=======================================+=========+============|
|                                       |         |            |
|PLANDER: Palm Planet Lander            |  $9.95  | __________ |
|---------------------------------------+---------+--------+---|
|                                       |         |
| California orders add 7.75% Sales tax | _______ |
|---------------------------------------+---------+
|                                       |         |
| ****US DOLLARS ONLY!****       TOTAL: |         |
+=======================================+=========+


EMAIL ORDERING:  You may fill this order form out and mail it to
sales@plbm.com if you prefer.
