Screensaver Registration Form

PLEASE NOTE: The "Registration Name" you give below must be EXACTLY the same as the one you wish use in the screensaver registration window (case sensitive).

Select the name of the screensaver you are registering in the pull down menu below and print this form, fill it, out and fax or mail it to us.  If an e-mail address is provided, we will e-mail you your Registration/Unlock Key, otherwise it will be faxed or mailed to you.

Registration Name
Title
Organization
Address 01
Address 02
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail
URL

Screensaver Name

Encounter With Sacred Space Mystical Journey In Chaco canyon Zion Canyon, Utah

CREDIT CARD INFO
Credit Card Type	VISA /MC (circle one)
Name on Card
Card Number
Expiration Date	mm/yy
Donation Amount

Your donations are greatly appreciated,
and help support the Spirit Heart Global Project.

 

MAIL OR FAX COMPLETED FORM TO:

Spirit Heart Sanctuary
P.O. Box 22658
Santa Fe, NM 87502

PHONE: (505) 424-1052
FAX: (505) 474-0307

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