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MAIL ORDERFORM

PLEASE PRINT OUT THIS FORM

 

BILLING ADDRESS

NAME
  
ADDRESS  
CITY  
STATE  
ZIPCODE  
COUNTRY  
PHONE  
E-MAIL  

SHIPPING ADDRESS

(IF DIFFERENT OR IS A GIFT)

NAME  
ADDRESS  
CITY  
STATE  
ZIPCODE  
COUNTRY  
PHONE  
E-MAIL  

OPTIONS

Make Payable To Common Sense Design's

International Money Order Checks (Will send plans out when check clears) CANADIAN FUNDS

ORDER

ORDER
NAME OF ITEM
PRICE
PLAN #1    
PLAN #2    

CANADIAN FUNDS - TOTAL

 

 

SPECIAL INSTRUCTIONS

 

MAIL TO

Payable To Common Sense Designs
In Care Of Gerald Estes
2477 Enefer Rd
Nanaimo, BC
V9X 1W4
Phone (250)323-4670
E-Mail - mariner_csb@yahoo.ca

 
 
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