Video Order Form
Name
Address
City, State, Zip
e-mail address
Telephone number
TITLE
QUANTITY
PRICE EACH
TOTAL
The Moore Method
19.95
One Step Behind
19.95
Subtotal
Tax
(California residents only, 8.25%)
Shipping
($3.00 first video, $1.00 each additional video)
TOTAL
Credit card type
Visa
Mastercard
American Express
Credit card number
Expiration date
