Fax or Postal Mail Order Form

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Orders
101 Dating Ideas
141 North 300 East
Spanish Fork, Utah, USA 84660

Utah residents add 6.25% sales tax:	$__________

Orders outside of the USA and Canada add $6:	$__________

Total enclosed US funds:	$__________

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Print your name below exactly as it appears on the card!

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Shipping Address (if different from billing address):

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