Please print and mail the completed form with $5.00 for shipping and handling to:
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Robert
Nelsen
P.O. Box 493669
Redding, CA 96049-3669
SHIPPING & HANDLING $5.00
Check Enclosed (Please make payable to Robert Nelsen)
VISA or
MasterCard
I__I__I__I__I__I__I__I__I__I__I__I__I__I__I__I__I__I
exp.___/___
PLEASE RUSH MY ORDER TO:
Your Name:________________________________________________________________________
Address:__________________________________________________________________________
City: _____________________________________________ State: _________ Zip:
_____________
E-mail Address: __________________________________ (required)
Telephone: ( ______ ) __________________________
Signed: __________________________________ Date:
__________________________________
Print this Form
P.O. Box 493669 Redding, CA 96049-3669 SHIPPING & HANDLING $5.00
PLEASE RUSH MY ORDER TO: Your Name:________________________________________________________________________Address:__________________________________________________________________________ City: _____________________________________________ State: _________ Zip: _____________ E-mail Address: __________________________________ (required) Telephone: ( ______ ) __________________________ Signed: __________________________________ Date: __________________________________ |
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