PRIMITIVE ARTS VIDEO

Ship To Information:


Name: Date:
Address:
Phone: (        )  Email:    
City State: Zip Code:

 

Quantity
Description
Unit Price
Price
       
       
       
       
       
*Sub-Total:
 
*Shipping & Handling:
 
*Total:
 

Complete the form above and mail with a *cashier's check or *money order to:

Primitive Arts Video
P.O. Box 4846
Overland Park, KS 66204

*US Dollar only

**Allow 4 weeks delivery on personal check orders.