ORDERING  BY  MAIL
Light Moves
ATTN: Order Processing
P.O. Box 22
Polvadera, NM  87828
You may print out this order form, or, if you prefer,
write out the relevant information on a separate sheet.
Send the completed form along with your payment to:
Quantity          Price                        Total
LIGHT MOVES Transformational Exercise DVD    _____ @ $19.95 each
 =
 $  __________


Shipping & Handling per order (for any number of DVDs):

USA:   ___ First Class: FREE  
 ___ 2-3 Day Delivery:  $6.75
 ___ Overnight Delivery:  $17.95
Canada:  $ 4.95




+
       


                                                           
                                                           
__________
                                                                                Sub-total
 =
 __________
New Mexico residents add 6% state tax (sub-total x .06)
 +
 __________
                                                                                TOTAL
 =
 $ __________
     
Payment:       __ Check     __ Money Order     __ Credit Card     __ Debit Card
Make check or money order payable to "Light Moves".  Please note
that if you pay by check, your order will be held until the check clears.
For Credit/Debit Card payments:    
Card type     __VISA   __MasterCard  __Discover  ___ American Express  __Diners Club
Card number:  ___________________________________
Card ID (last 3 digits on back of card) _____________
Expiration:       ____________
Name as it appears on card:  _______________________________________

Signature (required):              _______________________________________
Billing address if different from shipping address above:
Name _________________________________________
Street Address:  ___________________________________
City:  __________________________________ State/Prov  ___________
Zip/Postal Code__________     Country___________
Ship to:   Name _____________________________________
        Street Address ____________________________________
        City ______________________________   State/Prov ____________
        Zip/Postal Code __________     Country___________