FILL-IN, then PRINT, then FAX OR MAIL: This form will not automatically calculate the shipping and handling, subtotal or total, you need to do that yourself and type in the correct amounts.

* denotes required fields

Quantity	Product(s) Desired	Cost Each	Line Total
	Sacred Time Screensaver CD	$16.00 ea.
	Encounter With Sacred Space Video - Standard NTSC VHS [USA]	$20.00 ea.
	Encounter With Sacred Space Video - PAL VHS [Europe]	$23.50 ea.
Shipping & Handling Rates USA: VHS Videos - (1qty)+$3.50 / (2qty)+$5.50            (3qty)+$7.64 / (4qty)+$9.70 / (5qty)+$11.78            CD's - (1qty)+$1.70 / (2qty)+$2.60 / (3qty)+$6.30 Int'l: just leave the box blank, we'll calculate rates         and contact you to get your final approval		*Subtotal add line totals
		*S&H from table at left
tax deductible and appreciated  Additional Donation
this is the amount to be charged to your credit card		*TOTAL
Shipping Information
*Name
*Street Address
Address (cont.)
*City
*State/Province
*Zip/Postal Code	if no code type "none"
*Country
*Contact Phone
FAX
*E-mail
	Credit Card Information
*Card Type	VISA MasterCard PayPal	if you select PayPal, we will contact you via e-mail with transfer instructions
*Name on Card
*Card Number
*Exp. Date	mm/yy
	I am paying with a check or money order
Make payable to "Spirit Heart Sanctuary." If you are not in the USA, make sure you send a Bank Check payable at a USA bank, or International Travelers Checks will work nicely as well. All payments must be payable in US Dollars. Your credit card will be charged the TOTAL amount shown above. If there are errors in your math we will make the adjustment for you and let you know.

 

FAX or MAIL this completed form to:
Spirit Heart Sanctuary ~ P.O. Box 22658 ~ Santa Fe, NM 87502
FAX: 505.474.0307

Once we have received your payment we will postal mail the products ordered to you.

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