Destination Cinema Whales
Video, CD, Cassette
Order Form

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Steps to order the Whales Video, CD, or Cassette.

1. Using the print command from your browser, print this page.
2. Fill out the form completely.
3. Fax or mail in the form with payment

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MAILING INFORMATION:

Name	__________________________________________________
Address	__________________________________________________
City	____________________	State	_____	Zip	__________	Country	______
Telephone	____________________	E-mail		____________________

ORDER INFORMATION:

Video:	____	Quantity:	_____
CD:	____	Quantity:	_____
Cassette:	____	Quantity:	_____

PAYMENT METHOD:

_____	check or money order (enclosed with mail in orders only)
_____	credit card (include information below)

_____

Visa

_____

Mastercard

Card Number:	_______________________
Expiration Date:	_______________________
Name on Card:	_______________________

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