|
Peace of Body Peace of
Mind ~ |
Reinforcements |
| U.S. Orders: |
$18.75 |
$4.95 |
| All other countries: (U.S. funds please) |
$23.95 |
$5.75 |
All prices include shipping
and handling. All orders will be filled within 5 days |
** Please print this form by using the [print] key
on your browser.
Order Information: (please print)
Name
______________________________________________________________
Street Address _____________________________________________________________
Address (con't) _____________________________________________________________
City ___________________________________
State/Province ____________________Zip/Postal code _______________
Country _______________________________
E-mail Address ____________________________________________________
Phone Number (______)___________________________________
(required for credit card and check payments)
Number of Copies ________________
Total Payment Amount ________________________
Payment Type: VISA _____ MC______ Check______ Money Order_____
Credit Card Account Number __________________________________________
Expiration Date: month ______ year _____
Name as it appears on card __________________________________________
- Thank You for Your
Order
Please send completed
order forms and payment to:
PLJ Unlimited
P.O. Box 5452, Peoria, AZ 85385-5452
