Calendar Order Form

Please provide the following contact information:

First Name
Last Name
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code	xxxxx
Country
Work Phone	xxxxxxxxxx
Home Phone	xxxxxxxxxx
FAX	xxxxxxxxxx
E-mail

"We have never sold, traded, nor released our mailing list and will continue this policy."

	ORDER INFORMATION
1 copy of '09 Lunar Calendar, $23; 2/$45; 3/$67, 5/$108; 10/$199; 13/$233
QTY	DESCRIPTION	TOTALS
	Subtotal	Subtotal
	Mass residents add 5% tax	Tax
	Shipping charges:    1-3 copies /$6.50;  4-7/$11;  8-12/$12;  13 or more Luna pays!	Shipping
	Donation to help us move forward, thank you!	Donation
	Charge my credit card a total of:	Total

 

	BILLING
Credit Card	VISA MasterCard
Cardholder Name
Card Number	xxxxxxxxxxxxxxxx
Expiration Date	xx/xx
CVC Code	xxx  (Security code from back of card)

	SHIPPING
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code	xxxxx
Country
Date	xx/xx/xx
Comments or special instructions. Please write info here if you have trouble using our order form