ATARI DEMO CLUB  -  Bestellschein
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      Name   :                     Straáe :

      PLZ/Ort:                     Telefon:

      Mitglied:  ja ( )  nein ( )

      Altersangabe:

      Versandkosten:  per Nachnahme 10.00 DM       ( )
                      Vorkasse - Scheck 5.00 DM    ( )
                      Vorkasse - Bar 5.00 DM       ( )


      BESTELLUNG:
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      Gesamtbetrag :

      Datum:               Unterschrift: