Order the "A Day with Annie" video series

Phone Or Fax Order Form
Print this page, fill out form and fax to 1-310-966-1146, OR call toll free 1-800-278-7176 to order your video(s) today!

First Name ________________________Last Name __________________________

Mailing Address _______________________________________________________

___________________________________________________________________

City _____________________ State ____ ZIP/Postal Code ________________

Phone _____________________________

Please send me ______ copies of "A Day With Annie at the Circus!"
Please send me ______ copies of "A Day With Annie on the Farm!"
Please send me ______ copies of "A Day With Annie in the Sky!"

Total Number of videos being ordered = _______ x $19.95 each	=$ ________
Shipping & Handling $4.00 per video	+$ ________
ND residents pay 5% sales tax ($1.20/video)	+$ ________
Total Payment	=$ ________

Credit Card (Circle One) Visa / Master Card

Credit Card Number _________________________________ Expiration _____________

Cardholder Signature ___________________________________