To order your DocuMentor Collector's Record, print out and complete the form below and mail it with your money order or check (made payable to DocuMentor) to:

DocuMentor
P.O. Box 2146
Front Royal, VA 22630



ORDER FORM

Price Each Quantity Total
$72.50 _______ ____________



TOTAL ORDER:

Total Price for DocuMentor(s): $____________

Total Tax (Virginia residents 5%: $3.63 each): $_________

TOTAL ORDER $__________

Amount Enclosed $__________

Send my order to:

Name ____________________________________________

Address __________________________________________

City _____________________________________________

State _____________ Zip Code _______________________

Telephone( in case clarification is needed) _________________