ORDER FORM

(Please print this out to mail in an order)

BLACK RABBIT VIDEO, INC., P.0.2622, Orangeburg, SC 29116 - 1-8OO-5RR-XING

FROM: _________________________________________

______________________________________

______________________________________

(Please include your Street Address for UPS shipping)

 

Part Number 1237- "WHAT THE HECHT - TRAINS"

Video Tapes Price $19.95 plus $3.95 Shipping & Handling

Enclosed: Check ___ Money Order ___

Credit Card: MC ___ Visa ___ Expiration Date: _________

Number:_________________________________________

Signature: ________________________________________

Thank you for printing out this form & mailing in your order. We look forward to serving you now and in the future.

THE STAFF AT BLACK RABBIT VIDEO

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