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Print Out and Return
this Form by U.S. Mail or Fax (listed below)
Order Form
"In the Tradition of the Early California Vaqueros"
Hackamore Basics, Volume 1
Name:__________________________________________________
Street Address or
P.O.:_____________________________________
Mailing Address if
Different from above:______________________________________
City:__________________________State:___________Zip:________
Country or
Providence:______________________________________
Telephone:_____________________Fax:_______________________
e-mail address:
____________________________________________
(please print clearly)
VHS____
DVD_____ (please check which format you are ordering)
_____ Number of Videos Ordered
_____Number of DVD's Ordered
$____Amount due at $25.00 each
_____Check/Money Order Enclosed
in the above amount--make Payable to LORRY WAGNER
_____Payment by Credit Card
____Master Card ____Visa
Card No.
_______________________________________
Expiration Date:
__________________________________
X_____________________________________________________
(Signature of Card Holder)
Mail to:
Lorry Wagner
Sierra Dawn Arabians
8222 Athel
Street
Inyokern,
California 93527
(760) 377-5579 Fax: same number, no need to call ahead
e-mail: Lorry Wagner |
