Order Form
 

                        

Order Form


Please be assured that we have taken extra steps in making this a secured site for your protection.
To order your copy of the Perfect Roommate, please fill out the following Information.

ORDER THE PERFECT ROOMMATE

Please provide the following ordering information:

Your First Name
Your Last Name
E-mail:
Telephone:
Example: 619 555-1212

Shipping Information

Street Address
City
State/Province
Zip/Postal Code
Country

Billing Information

Credit Card
Cardholder Name
Card Number
Expiration Date Example 08/02

Order Quantity

QTY DESCRIPTION

  Unit price $24.95
NOW ON SALE $15.95
  Plus Tax and Shipping & Handling
Calif. Residents include sales tax



Copyright © 1999 P.J. Publishing. All rights reserved.
Revised: March 23, 2004

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