FAX &MAIL ORDER FORM  

Date__________________________

CUSTOMER BILLING/SHIPPING INFORMATION:

Name______________________________________________________________________

Organization_________________________________________________________________

Address_____________________________________________________________________

City__________________________ State______________________ ZIP______________

Country_______________________

E-Mail Address_______________________________

Phone (______)_______-_________Fax (______)_______-_________

ORDER INFORMATION:

Product Price Quantity Ordered
Two volume DVD Set of The Passion of the Mao $400  

Shipping & Handling: (allow 2-6 weeks for delivery)
US & Canada: $15 for 1 product, $10 each add'l Shipping
International (Outside US & Canada): $25 per product

See left  
Tax (Illinois residents add 8%)    
TOTAL    

PAYMENT INFORMATION:

___Check/Money order enlcosed (US funds only)

___Visa ___Mastercard ___Discover ___AmEx

Credit Card Number _______________________________________

Exp. Date_______

Signature__________________________

INSTRUCTIONS:

(1) Print and fax this order form to 01-845-774-2945 or (2) Copy information and email to info@transitmedia.net
or (3) Call Transit Media at 1-800-343-5540 or 01 845-774-7335 or (4) Mail this order form to:
Little Red Book Production Company, LLC, Library
190 Route 17M, P.O. Box 1084
Harriman, NY 10926