| Order Form |
| Please print this form out, fill it out and mail it in with your check or money order for $9.95 plus $3.95/ shipping and handling total $13.90 to: |
| R. Harris 1522 W. Wahalla Lane Phoenix, AZ 85027 |
| NAME:___________________________ |
| ADDRESS: ________________________ |
| __________________________________ |
| CITY: _________________________ |
| STATE: ________ |
| ZIP: __________ |
| E-MAIL:____________________________________________ |
| CHECK PREFERRED METHOD OF DELIVERY: |
| PLEASE SEND SNAIL MAIL |
| PLEASE SEND VIA E-MAIL |
| _______ |
| _______ |
| THANK YOU FOR YOUR ORDER. I AM SURE YOU WILL LOVE YOUR NEW PERSONAL SCREENSAVER. PLEASE ALLOW 2 WEEKS FOR DELIVERY! DON'T FORGET TO INCLUDE YOUR PICTURES AND SOUNDS. SEND THEM BY E-MAIL TO : [email protected] WHEN YOUR FUNDS HAVE CLEARED, YOU WILL RECIEVE YOUR SAVER WITHIN 2 WEEKS! |