ORDER FORM

KINESIS
PO Box 586
Hanover, MD 21076-0586
US
www.kinesiscd.com

ORDERED BY (include email address)
(Must match billing address for credit card orders):

 

 

 

Please charge my Visa, MasterCard, Discover or American Express:

     		               _                    _                    _                    
Expiration
(MM-YY)

     		     _          


SHIP TO (if different):

 

 

QTY

DESCRIPTION

PRICE EACH

TOTAL

    
    
    
    
    
    
    
    
    
    
    
    
    

Subtotal _______________

Maryland residents add 6% sales tax _______________

Shipping _______________

TOTAL $ _______________