ORDER FORM FOR GONTZA GAMES PRODUCTS
PLEASE PRINT AND MAIL TO ADDRESS BELOW.
NAME__________________________________________________
SHIP TO ADDRESS________________________________________
DAYTIME PHONE: _______________________________________
EVENING PHONE: _______________________________________
EMAIL ADDRESS: _______________________________________________
MINDFIELD: $52.40 EACH
CHRISTMAS CARDS: $17.85 EACH
PASS THE GROGGER!: $15.73 EACH
# MINDFIELD: ____________________ X $52.40 = TOTAL DUE: ____________
# CHRISTMAS CARDS: _____________ X $17.85 = TOTAL DUE: ____________
# PASS THE GROGGER!:____________ X $15.73 = TOTAL DUE: ____________
COUPON CODE: _____________ DEDUCT FROM TOTAL DUE: ____________
# GAMES ORDERED: _____________
TOTAL DUE FOR ALL GAMES: $_______________________
PLEASE MAKE CHECK OUT TO GONTZA GAMES AND MAIL TO:
GONTZA GAMES
PO BOX 1191
ROSLYN, PA 19001
QUESTIONS? CALL 215-605-5231
HOW DID YOU HEAR ABOUT GONTZA GAMES? _____________________
THANK YOU FOR YOUR ORDER!