ORDERING  BY  MAIL
Light Moves / Susan Barclay
ATTN: Order Processing
5
2 Valley Loop Road
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___________