TRUUCHA™
HOPPERS ONLY VIDEO
ORDER FORM

 FROM: (print clearly) Print Out Form

Name ____________________________
Address__________________
City____________________
State_________ Zip__________
Phone (___)________________
E-mail Address______________

send order form to:
PlaqueWerkz
9352 San Fernando Road
Sun Valley, CA 91352

Quantity Description Cost
 
TRUUCHA™  HOPPERS ONLY Volume #11

$ 20.00ea.
 
TRUUCHA™  HOPPERS ONLY Volume #10

$ 20.00ea.
 
TRUUCHA™  HOPPERS ONLY Volume #9

$ 20.00ea.
 
TRUUCHA™  HOPPERS ONLY Volume #8

$ 20.00ea.
  TRUUCHA™  HOPPERS ONLY Volume #7
$ 20.00ea.
 
TRUUCHA™  HOPPERS ONLY Volume #6
$ 20.00ea.
    Subtotal  
    Shipping & Handling  
    Total  

CHECK

VISA MC 

MONEY ORDER

COPY ACCOUNT NUMBER FROM YOUR
VISA, MASTERCARD OR
AMERICAN EXPRESS
CARD

                               

MONTH

YEAR

EXPIRES
   
   

________________________

CARDHOLDERS SIGNATURE

All mail in orders must be accompanied by payment !

CARD ORDERS MUST BE MADE BY ADULT CARDHOLDER!

Please specify credit card type.

Money Order or Cashiers checks accepted.  No personal checks or COD's.

Shipping : UPS Ground

USA = 5.00 per package
Canada = $6.00 per package
International = $8.00 per package
S&H charges apply to 5 videos or less per package.

Thank You for your business !