AMERICAN ORDER FORM for SIGN IT!

HOW TO ORDER

PLEASE CHECK REQUIRED POSTAGE FOR "CANADA"

  1. PLEASE FILL IN ALL BLANKS THAT APPLY AND THAN PRINT OUT ORDER FORM.
  2. ENCLOSE CHECK OR MONEY ORDER FOR TOTAL $US AMOUNT CALCULATED.
  3. PLEASE MAKE CHECKS, MONEY ORDERS, PAYABLE TO: PERMANENT REFLECTIONS
  4. MAIL THE ORDER FORM AND ENCLOSED PAYMENT TO:

PERMANENT REFLECTIONS 206 BROWNING AVE. TORONTO ONTARIO,

CANADA M4K 1X2

TYPE IN ORDER INFORMATION

INSTITUTION:
ORDERED BY:
DEPARTMENT:
FIRST NAME:
LAST NAME:
ADDRESS:
CITY, STATE, ZIP CODE:
PHONE #:
GAMES WITHOUT BOOK: @ $15.00 EA.:
SHIPPING AND HANDLING: $15.00/GAME:
TOTAL AMOUNT:: $AMERICAN:

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