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ORDER FORM

KINESIS INC.
PO Box 586
Hanover, MD 21076-0586
US
www.kinesiscd.com
Fax:

ORDERED BY (include email address)
(Must match billing address for credit card orders):

 

 

 

Please charge my Visa, MasterCard, Discover or American Express:

     		                   _                         _                         _                        

Expiration
(MM-YY)

     		       _            


SHIP TO (if different):

 

 

QTY

DESCRIPTION

PRICE EACH

TOTAL

       
       
       
       
       
       
       
       
       
       
       
       
       

Subtotal _______________

Maryland residents add 6% sales tax _______________

Shipping _______________

TOTAL $ _______________