mail anywhere

USA MAIL ORDER FORM

Name:

Address:

City:

STATE::

ZIP:

Payment Method: Visa ( ) Cheque ( ) Money Order ( )

If paying by Visa,Card number.

four number expiry date:

Please Make Cheques Payable to Mickymar Productions Ltd.

Please print this order form, fill out and Mail To

EFC DISK

86 McGill Street,

Toronto ON

M5B 1H2

Canada.

If Paying by cheque remember to enclose

Please Make Cheques Payable to Mickymar Productions Ltd.

Please allow 3 weeks for delivery