Infinifield, Inc.

P.O.Box 7302, Buffalo Grove, IL 60089

Print this form, fill-out, and fax it toll-free to 1-866-279-9055

ORDER FORM

#	Item Description	Price	Quantity	Amount
1.	Infinifield® board game (tax included where applicable)	$19.99	x ___ =	$___________
2.	Flat rate shipping (any number of sets to the same address)	$5.00		$5.00
	Total:			$___________

Is this order a gift (circle)?    Yes    No     (we will not include price information in gift orders)

Ship To:

Name:              

Address:          

City/State/Zip:  

Bill To (only if different from Ship To):

Name:              

Address:          

City/State/Zip:  

Credit Card:

Card Type (circle one):   Visa    MasterCard    (sorry, we only accept Visa and MasterCard)

Credit Card Number:      

Expiration Date:            

Signature:                    

All orders will be shipped within 24 hours. Orders placed between December 24, 2005 and January 2, 2006 will be shipped on January 3.