Print this order form, fill it out, and send it in with the payment. Feel free to add items to your order or order in quantity. Just fill out what you would like and send it along with your check or money order. All prices include shipping. Game Doctors Order Form Quantity Description Price Total Price ------------------------------------------------------------------- Playstation Items ____ Playstation DualShock System 121.00 _______ ____ Dual Shock Controller 28.00 _______ ____ 15 Block Memory Card 7.75 _______ ____ 240 Block Memory Card 25.00 _______ ____ Playstation Link Cable 9.90 _______ ____ Playstation Controller Extender 9.90 _______ ____ Playstation RF Switch 12.00 _______ ____ Playstation Power Cord 5.90 _______ ____ Playstation Multi-Tap 27.90 _______ ____ Official Playstation Case 29.90 _______ ____ Frogger 22.00 _______ ____ Namco Museum Vol. #1 22.00 _______ ____ Namco Museum Vol. #3 22.00 _______ ____ Doom 22.00 _______ ____ Tomb Raider 22.00 _______ ____ Die Hard Trilogy 22.00 _______ ____ Cool Boarders 2 22.00 _______ ____ Crash Bandicoot 1 22.00 _______ ____ Crash Bandicoot 2 22.00 _______ ____ Destruction Derby 22.00 _______ ____ Resident Evil: Director's Cut 22.00 _______ ____ Ridge Racer 22.00 _______ ____ Alien Trilogy 22.00 _______ ____ 2-Extreme 22.00 _______ ____ Super Puzzle Fighter 2 22.00 _______ ____ Tekken 22.00 _______ ____ Tekken 2 22.00 _______ ____ Twisted Metal 2 22.00 _______ ____ Mortal Kombat Trilogy 22.00 _______ ____ Jet Moto 22.00 _______ ____ Tetris Plus 22.00 _______ ____ Soulblade 22.00 _______ Nintendo 64 Items ____ Nintendo 64 System w/Controller 121.00 _______ ____ Standard N64 Memory Card 8.90 _______ ____ 4X N64 Memory Card 16.90 _______ ____ N64 Game Shark 42.00 _______ ____ N64 Controller Extender 9.90 _______ ____ N64 Audio/Video Cables 5.90 _______ ____ N64 RF Switch 12.90 _______ ____ NBA Courtside 37.00 _______ ____ Super Mario 64 37.00 _______ ____ Diddy Kong Racing 37.00 _______ ____ Mario Kart 64 37.00 _______ ____ Wave Race 64 37.00 _______ ____ James Bond 007: Goldeneye 37.00 _______ Super Nintendo Items ____ Super NES Controller Extender 7.90 _______ ____ Super NES Audio/Video Cables 5.90 _______ ____ 16 Bit Universal RF Switch 7.90 _______ ____ Super NES Mouse w/Pad 7.90 _______ Sega Genesis Items ____ Sega Genesis Controller Extender 7.90 _______ ____ Sega Genesis Model 1 RF Switch 7.90 _______ Game Boy Items ____ Original Gameboy AC Adapter 7.90 _______ ____ Pocket Gameboy AC Adapter 9.90 _______ ____ Pocket Gameboy Battery Pack 7.90 _______ Game Gear Items ____ Game Gear AC Adapter 9.90 _______ ____ Game Gear Car Adapter 7.90 _______ Sega Nomad Items ____ Sega Nomad AC Adapter 9.90 _______ ____ Sega Nomad Car Adapter 7.90 _______ Miscellaneous Items ____ Video Game Selling Kit 3.01 _______ ____ Playstation Game Shark Guide 9.90 _______ ____ N64 Game Shark Guide 9.90 _______ ____ Pokemon Text Strategy Guide 9.90 _______ ____ Zelda: Orcana of Time Text Guide 9.90 _______ ____ Atari Jaguar System 39.00 _______ ____ Atari Jaguar Extension Cables 9.90 _______ ____ Atari Jaguar Composite AV Cables 9.90 _______ ____ Atari Jaguar Team Taps 9.90 _______ Grand Total _______ Mail To: Game Doctors Name:_______________________________ c/o Benjamen Hebert Address:_______________________________ 213 North 76th Street City:___________ State:___ Zip:_____ Omaha, NE 68114 Phone(optional):_____________________