Restoration CD Order Form

DaKara Kies Company P.O. Box 4338 Everett, WA 982704

(425) 267-9738 OR 1-800-813-3877

Fax 425-953-4304

Print out, complete, and mail this form to the address above

E-mail: (Cut & Paste form): dakara@dakara.com

Ship to:

Name___________________________________________________________________
Address_________________________________________________________________
City_____________________________________________ST______ZIP____________
E-Mail Address___________________________________________________________
Phone#(_______)_________________________________________________________
VISA/MASTERCARD #____________________________________________________
CVV________ (Last 3 digits on the back of your card in the signature line) EXP_____-_____

SIGNATURE____________________________________________________________

Description  		            	Qty		Price		Total
            
Restoration			        _____		$14.95      ____________

 

				 		        Sub Total        $_______________

		                  Shipping & Handling  (see chart)       $_______________

		            	   
                      		              Total	                 $_______________

Shipping & Handling (continental US only)
Order Amount S & H
1 CD $2.50
2 CD's $3.50
3 to 6 CD's $5.00
Over 6 CD's E-mail or call for price quote.

Surface (Foreign countries): add $5.00 (USD) to prices above. Please allow eight weeks for your order to arrive.

Air (Foreign countries): add $7.50 (USD) to prices above.

These shipping and handling charges are estimates. In some cases it may be necessary for charges to be adjusted.

Rainbow Woman is committed to the preservation of the Earth and makes a concerted effort to use and reuse recyclable materials. You may receive you order in an unusual package or with a combination of packing materials. We urge you to reuse whatever you can of the packing materials.

Thank you for your order!

Please mail this completed form to the address above or call with your Visa/Mastercard number.

dakara@dakara.com

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800-813-3877
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