WORLDWIDE BLACKJACK NETWORK OFFICIAL REPORT FORM

FAX OR MAIL COMPLETED FORMS TO
BLACKJACK REVIEW
PO BOX 541967, MERRITT ISLAND, FL 32954
VOICE AND FAX 407-452-2957
EMAIL = mdalton@BJRnet.com


DATE / DAY: _________________ TIME: _________________ REPORTER: ________________

CASINO: _____________________ LOCATION: ____________ CITY/COUNTRY: ___________

TOTAL NUMBER OF BJ TABLES IN CASINO: ____________ IS THIS AN ESTIMATE? _____

# DECKS ______ # TABLES ______ OPEN ______ $MIN/MAX BETS _____________________

RULE VARIATIONS _____________________________ PENETRATION __________________ 

# DECKS ______ # TABLES ______ OPEN ______ $MIN/MAX BETS _____________________

RULE VARIATIONS _____________________________ PENETRATION __________________ 

# DECKS ______ # TABLES ______ OPEN ______ $MIN/MAX BETS _____________________

RULE VARIATIONS _____________________________ PENETRATION __________________ 

SHOE GAME SHUFFLE PATTERN: _________________________________________________

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NOTES: ________________________________________________________________________

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PENETRATION CODES:		P = POOR (less than 65%) 
 			  	G = GOOD (greater than or equal to 77%)   
				V = VARIES   
				A = AVERAGE

IF YOU DON'T HAVE COMPLETE INFORMATION WE STILL NEED YOUR INPUT!

THANK YOU