Printable Order Form DON'T LET LIFE LICK THE RED OFF YOUR CANDY!™
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Enter quantity next to selection ______ CD Audio Book - $49.95 plus 4.95 S&H (per program) Total Amount Enclosed: __________________________ |
Name_______________________________________________________________ Address _____________________________________________________________
____________________________________________________________________ Company ____________________________________________________________ Phone Number ________________________________________________________ |
Payment Type (circle one): ( MasterCard) (Visa) ( American Express) (Check) Card Number ________________________________________________________
Expiration Date (month/year) _________________/__________________________
Authorizing signature: _________________________________________________
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Fax this order form to (916) 632-8801
or mail with credit card information or check to:
Diversified Career Potentials
5098 Foothills Blvd., Suite 3-306
Roseville, CA 95747