Shipping:
__________ For USA and Canada
orders:
Add $5.00 if under $50.00
$8.50 ............. $50.00-$99.99
$12.50 ........... $100 - $150.00
If over $150, contact D.Y.S.
For Overseas orders:
Add $14.00 if under $50.00
$17.50 ............. $50.00-$99.99
$20.00 ............. $100 - $150.00
If over $150, contact D.Y.S.
TOTAL:
__________ Payable to "DEAFinitely
Yours Studio"
in U.S. Dollars and drawable on a U.S. Bank.
Enter your name and address below: (Fields in CAPS are
required.)
NAME
Company or
Organization
STREET
ADDRESS
Address
(if needed)
CITY
STATE/
PROVINCE
ZIP/
POSTAL CODE
COUNTRY
Work Phone
Home Phone
FAX
E-MAIL
FROM WHERE
did you hear about
this website?
URL Address
(if any)
Select one of three Payment Methods below:
Payment Method
(Select one)
Payment
Information
Check or Money Order
(If
paying by check or money order,
print this Order Form out and mail it.)
VISA
MasterCard
Credit
Card Information
Name as shown on the
card:
Account #: ---
Expiration Date:
Your Signature: _______________________________
Purchase
Order
(And, fax a copy
of it to: 301-593-0700)
Purchase
Order Information
Purchase Order
Number:
Account Name for this P.O. Number:
NOTE: Fax the original P.O. to 301-593-0700