Canada_Specials-Order-Form

CREDIT CARDS ONLY ACCEPTED
(not UK Bankers or Debit Card).

To see other DVDs and items from Creation Research click WEB SHOP

SECURE CANADA SPECIAL DVD PRICE ORDER ALL FOUR FOR $75.00 GET 1 FREE or $25.00 each - Climate Change - The God Factor, Climate Change & Creation & Are you Born Homosexual?

Welcome to the easy FIVE step ORDER process.

1 Client Details
Date:
Title:
First Name:
Surname:
Company:
Position:
2 SHIPPING DETAILS
Address:

Suburb:
State:
Country:
Post Code:
3 CONTACT DETAILS
Contact No.:	A/H Phone:
Fax:
Email:

4 ORDER DETAILS
Qty	Item	Click arrow for Product title and Prices. (all prices inc. GST)	Post Free
	Item 1		1 DVD, $25.00 each All four for the price of $75.00 *GET 1 FREE*
	Item 2
	Item 3
	Item 4
	Item 5

5 PAYMENT DETAILS
Value:
Total Amt payable:
Card Type:
Card Number:
Expiry Month:	/ Year:
Name on Card:
For security purposes:		Please turn your credit card over and copy the last three digits in text box below.

PLEASE RECHECK THAT ALL THE BOXES MARKED WITH HAVE BEEN FILLED IN BEFORE YOU PROCESS YOUR ORDER THEN CLICK