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Name ______________________________________________________________________________ Date ________________200__ Address ____________________________________________________________________________ City ___________________________________________ Province/State ___________________________________ Country ________________________________________ Postal/Zip Code _____________ Telephone # area code (_____) ______________________ e-mail (if available)___________________________ @_________________________________ Retail Price: $69.95 (plus $10.00 shipping &
handling each). Quantity________ Total amount enclosed with this Order Form $_________ -------------------------------------------- Spirit Wrestlers Publishing
If there are any questions, please fax (613-737-5778)
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