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*                                                       *
*       ORDER FORM FOR BURP ME! ADD ON PROGRAMS         *
*                                                       *
*         Please make a printout of this Form           *
*                                                       *
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*                                                       *
*  Please fill out the questions below:                 *
*                                                       *
*  Name:_____________________________________________   *
*                                                       *
*  Address:__________________________________________   *
*                                                       *
*          __________________________________________   *
*                                                       *
*  Is this the address where you wish to your add-on    *
*  programs disk to be sent?    Yes___    No___         *
*                                                       *
*  If not, where should the disk be sent?               *
*                                                       *
*  Address:__________________________________________   *
*                                                       *
*          __________________________________________   *
*                                                       *
*  What is your E-mail address?______________________   *
*                                                       *
*  Have you visited the web site, "Sicnarf the Eel's    *
*  Home Page o' Fun?"           Yes___    No___         *
*                                                       *
*  Where did you hear of the BurpMe! program?________   *
*                                                       *
*  __________________________________________________   *
*                                                       *
*  __________________________________________________   *
*                                                       *
*  Do you have any comments on the program?__________   *
*                                                       *
*  __________________________________________________   *
*                                                       *
*  __________________________________________________   *
*                                                       *
*                                                       *
*   THANK YOU FOR TAKING THE TIME TO FILL THIS OUT!     *
*                                                       *
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*                                                       *
*                                                       *
* Please send a copy of this form & your check or money *
* order for $5.00 (made out to Lee Francis) to:         *
*                                                       *
*	Sicnarf the Eel					*
*	c/o Lee Francis					*
*	10023 128th St. E., Suite 1			*
*	Puyallup, WA 98373				*
*                                                       *
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