QUANTITY PRODUCTS DESCRIPTION PRICE TOTAL

$ 4.00
$ 2.00
$ 5.00
$ 3.00
$ 7.50

$ .32 per Card
$ 5.00 per Month
$ 10.00 per Month
$ 399.00 Per Aid
Custom Made Martial Arts Video Tapes
Weapons Use and Defense
Increase Striking Power 50% to 100% in One Lesson
Multiple Attack Defense
Slick Tricks for Ending a Fight

These martial arts tapes have been ordered in the past, but each tape is custom made for your specific needs. If you have an idea request it. Multiple selections are allowed or make your request in the description
$ 69.00 Per Tape
$9.95
 
 
 
 
NAME SUBTOTAL
ADDRESS Subtract Ship and Handle charges if your product or service does not require Shipping Ship & Handle - 15%
PHONE GRAND TOTAL
EMAIL  
Company  

Sensei Kirkham, I did not find these items on the order form at

My total including the orderform, extra items I could not find on the order form and the additional shipping is

Sensei Kirkham some of the information did not show during the printing of this order. Here is the extra information I would like you to have Information

If your order does not require anything to be shipped, please deduct the shipping and handling charges added to your order automatically.

I am printing this form and faxing you this order with a faxed check (U.S. and Canada Residents only). 1-808-593-2522. For this order to print properly click on file, click on page set up, click on landscape.

I am printing this form and faxing you this order with an ITEX faxed check . 1-808-593-2522. For this order to print properly click on file, click on page set up, click on landscape.

I am requesting an auto-reply email form to give you my check information. I understand there is no need to fill out the order again as long as the email addresses are the same as this order (U.S. and Canada Residents only). Make sure you are logged onto the Internet.

I will fill out my check information on line here. I understand there is no need to fill out the order again as long as the email addresses are the same as this order (U.S. and Canada Residents only). Make sure you are logged onto the Internet.

I will pay by credit card on line here. I understand there is no need to fill out the order again as long as the email addresses are the same as this order (U.S. and Canada Residents only). Make sure you are logged onto the Internet.

For this order to print properly click on file, click on page set up, click on landscape.

I am snail-mailing my printed order and check to you to:

James R. Kirkham

60 S. School #23

Honolulu HI 96813 (still a standard U.S. stamp)

To order INSTANTLY by check just fill out the following form and click submit at the bottom of the form or you can receive a form in your email to fill out by click here.

The following fields are ALL REQUIRED!

Account Holder's Name as it appears on the Check

Check Number (record this check in your check book)
check order sample Fractional ABA number (for USA banks only - looks like 91-210/1225
Address if it is different than shipping address. Pay to the order of
Amount of Check Name of Bank
9 digit Bank Routing or Transit Number (Canadians MUST put a hyphen in the 6th position - all funds are US Dollars) City and State or Province where Bank is located
Your Account Number (include spaces and hyphens)
 

I authorize You to use Version 3.0 KwikChecks software to print a check on my bank for the above selected items in the amounts shown. I understand that the check will show up just like any other check on my monthly bank statement. I also authorize you to draft my account electronically for the face amount of this check AND appropriate returned check fees if your check is returned unpaid. YOUR ORDER WILL NOT BE PROCESSED IF THIS LITTLE BOX IS NOT CHECKED!

This form will be processed without our having to re-type it. Please add a note in the comment field below if you would like information about our check processing software. (Please make sure the form is complete and accurate and NOTE that there will be a $20 charge for dishonored checks.)

Credit Card Orders

Warning: This is not a secured site. If you prefer to fill out your information then fax your order with your credit card information you may do so to receive your order. For this order to print properly click on file, click on page set up, click on landscape.

Name as it appears on Credit Card  
Type of Card  
Credit Card Number  
Expiration Date of Credit Card  

In order to speed up your order even more, you may hit your backspace after submitting your order and email me at my alternate email address to let me know I have an order. Don't be afraid to include important information again, I will not be insulted. As a dual certified in home tutor, I know that repetition never hurts anything.

James R. Kirkham
60 S. School St. #23
Honolulu HI 96813

http://tutor.hypermart.net

http://tutor.hypermart.net/tutoring.html

http://tutor.hypermart.net/martialarts_ezine.html

http://tutor.hypermart.net/martial_arts.html

http://tutor.hypermart.net/shareware.htm

http://tutor.hypermart.net/20dollars.htm