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  AGENTLE  TOUCH

_____________

DUSTIN GLEDHILL


ORDERING OPTIONS:
MAIL ORDERS:
"A Gentle Touch"
  1089 Cherry Lane
Provo, UT 84604
ON LINE :
 www.dustingledhill.com
   E-MAIL ORDERS: 
dustin@gledhill.com
 FAX:
1-801-374-1375 		PHONE ORDERS:
1-801-427-6493

NAME                                                                    PHONE (         )            -                                

ADDRESS                                                                                                                                  

CITY                                                                       STATE/PROVINCE                             

POSTAL CODE/AREA CODE                    aaaxx A.xAPT/STE#                  

COUNTRY                                          E-MAIL                                                                       

PRODUCT
CD - $14.95    ____           Quantity                   
TAPE - $8.95  ____           Quantity                   

SHIPPING
US/CANADA Standard Mail  $2.00  ____    Global Standard Mail   $3.00  ____

US/CANADA Priority Mail    $4.25  ____    .Global Priority Mail   $5.25  ____

PAYMENT INFORMATION 
SUBTOTAL (Without Shipping)    $ _______________
Specify Shipping    ____________$________________
TOTAL (With Shipping)       S .SA$ _________________

Check  ____                Money Order    ____

Cash    ____                *Credit Card    ____

*Credit Card #   __________________________________ Expiration Date ____/____
(Credit Card transactions are processed through: Cherry Lane Collection)

Name on Credit Card: