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| Please
send me the following items:
Method of Payment __ Money Order payable to: __ Visa __ Mastercard Credit Card Account Number _____________________________________ Credit Card Expiration Date: _____________________ Customer Signature (Required) _____________________________________ |
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| To
place an order choose one of the following:
1.) Phone:
1-800-544-1108 2.) FAX:
1-800-207-8182 4.) MAIL TO:
Please fill out the following for mail or fax orders: Name _____________________________________ Street Address _________________________ _____________________________________ City _____________________ State _______ Zip __________ Phone (___) _____________ |
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