California Residents: Only: $85.00
Other 49 States: $79.00

(Please allow at least 2 weeks for delivery)

NAME:

TITLE:

STREET: (No PO Box Numbers)

CITY: STATE: ZIP:

COUNTRY:

FAX: PHONE:

E-MAIL:

Make checks payable to: Jess Dines

MAIL TO:

Pantex International Ltd.
P.O. Box 17322
Irvine, CA 92623-7322
Facsimile (714) 560-0445
E-mail: jdines@cox.net

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