To order by check, money order, or credit card please print and complete this
form
and mail with your payment or credit card information to:
PO Box 21166 · Boulder, CO · 80308.
You will receive confirmation of your order within 7 days.
Please make checks out to Beth Amsel. |
| Billing Address: |
| Name_______________________________________________________________________ |
| Address_____________________________________________________________________ |
| City_________________________________________State________Zip________________ |
| Phone_______________________________Email___________________________________ |
| Payment Method ________Check _________Visa
_________Mastercard |
| Credit Card#_________ _________ _________ _________Expiration
date______/________ |
| Signature____________________________________________________________________ |
Shipping Address (if different than billing address): |
| Name_______________________________________________________________________ |
| Address_____________________________________________________________________ |
| City_________________________________________State________Zip________________ |
| Phone_______________________________Email___________________________________ |
