|
Please
print clearly
Fax
to (509)694-1193
Mail
to:
THC
Health
P.O.
Box 667503
Houston,
TX 77266-7503
| Name______________________________
Address___________________________ City________________________________ State/Province____________________ Country____________________________ Zip/Post code_____________________ Phone_____________________________ E-mail_____________________________ |
Credit card type_____________________________
Credit card number__________________________ Expiration date______________________________ Name on Card_______________________________ |
Please check the number
of product.
| 1 $1.50 each Plus $3.00
Shipping and Handling
10 $1.25 each Plus $3.00 Shipping and Handling 20 $1.00 each Plus $3.00 Shipping and Handling 1 Set of Twin Tower Bills Matted $24.97 Plus $5.00 Shipping and Handling 1 Set of George Bush Bills Matted $24.97 Plus $5.00 Shipping and Handling 1 Back Scratcher $9.97 Plus $2.00 Shipping and Handling |
$4.50 _______
$15.50 _______ $23.00 _______ $29.97________ $29.97________ $11.97________ |
Please Indicate The Number And Type Of Bill You Would Like To Order.
Bush Bills_________
Twin Towr Bills_________
Thank you,