Gymnastic Abs Printable Order Form
FAX this form To:
1-512-628-3490
Or
Mail This Order Form To:
Baran, Inc.
6312 SW Capitol Hwy. #444
Portland, OR 97239
___ Enclosed is my check, money order or credit card order for __________ copy(s) of Gymnastic Abs
for $119 plus $10.00 US S&H ($20 Canada, $37 foreign orders) each. (Please make checks payable to Baran Inc.)
Totalling $_____________._______
___ I want to do the 4 monthly EZ payments of only $29.75 for 4 months. (The $10 S&H charge only applies the first month). Please charge my card(s) $29.75 for
4 months plus the $10 S&H ($20 Canada, $37 foreign orders) for the first month.
Charge my (Note: You can use more than one card to complete this order):
Type of Card: ____________
Card Number:________________________________________ Exp. Date:_______
Type of Card: ____________
Card Number:________________________________________ Exp. Date:_______
Type of Card: ___________
Card Number:________________________________________ Exp. Date:_______
Signature: __________________________________________
Print Name: _______________________________________________________________________
Address 1: _________________________________________________________________________
Address 2: _________________________________________________________________________
City: ______________________________________ State: ______________
Zip Code: _______________________Country: _________________________________
Telephone: _______________________________________________
Fax Number: _____________________________________________
E-Mail: __________________________________________________
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