Meir Yedid Magic - Mail/Fax Order Form

Mail/Fax Order Form

TODAY'S DATE:	E-MAIL ADDRESS:
SHIP TO NAME:	PHONE NUMBER:
STREET ADDRESS:	METHOD OF PAYMENT: [_] CHECK - [_] MONEY ORDER [_] VISA - [_] MASTER CARD - [_] DISCOVER
CITY:	ACCOUNT NUMBER:
STATE/ PROVINCE:	EXPIRATION DATE:
POSTAL CODE & COUNTRY:	SIGNATURE:

SATISFACTION GUARANTEED

	QUANTITY:	DESCRIPTION:	UNIT PRICE:	TOTAL COST:
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SUBTOTAL:
POSTAGE: (USA: FREE — OUTSIDE USA: ADD 20%)
TOTAL:

Meir Yedid - P.O. Box 2566 - Fair Lawn, NJ 07410 - USA
Phone: (201) 703-1171 - Fax: (201) 703-8872
Click here to send e-mail: meir@mymagic.com