DVD Order Form

Please print and mail to:


Jade Woman Enterprises

1880 S. Pierce Street, Suite 14

Lakewood, CO 80232

303.573.6533


FIVE ELEMENT ACUPUNCTURE DVD SET

THE TWELVE OFFICIALS © Warren Bellows

ORDER FORM

___________Sets @ $195.00/set (6 DVDs) $______

Shipping and handling @ $10.00 per set $_________

Order Total $___________

Payment: Check#_________(please enclose)

Credit Card: VC____MC____

Credit Card#__________________________
Exp Date______

Signature Authorization:______________________________

Mail Order To: Please Print

Name:____________________________________

Address:__________________________________

___________________________________________

Phone#___________________email____________

Mail order with payment to Jade Woman Enterprises at the above address. Thank you!