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Interactive Game Programs Order Form...
    Please accept my order for the following Interactive Game Programs.


Interactive Game Programs (ELECTRONIC ORDER FORM)

Quantity Item No. Description Unit Price Total $
HP-1000 Ancient Chamori Warrior Game $625.00
HP-2000 Ancient Chamori Båtu Game $600.00
HP-3000 Ancient Chamori Tres Siete Game $600.00
Add Shipping & Handling Charge of $2.00 Per Diskette
Total Order $


Name:   

Address: 

City: State/Country:    Zip Code:

Daytime Phone: Evening Phone:

Please Bill my:    VISA   MasterCard   American Express:   JCB

Card Number: 

Expiration Date: 

E-Mail: 



                                                           


Pugua' International Corporation
1050 Bishop Street, Suite 200
Honolulu, Hawaii 96813
Tel: (808)247-8742
E-Mail: chamori@lycos.net

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