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We
recommend that
you print this order page.
Please complete and sign the copied
form and mail or fax it to us.
All prices are in US Dollars.

To
print this form select "file" on
your browser menu, then print.
Our fax number is 1-509-766-9423
| Name
on card |
|
| Address |
|
| City |
|
| State |
|
| Postal
Code |
|
| Country
(if not US) |
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| Area
Code/ Phone |
|
| FAX
or E-mail Address |
|
| Card
Type (MC Visa Amex) |
|
| Card
Number |
|
| Expiration
Date |
|
| Cardholder
Signature |
|
|