Order_form_TX_2012

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Send to: N. Ogasawara 128 Sparrow Dr. West Henrietta, NY 14586 USA ORDER FORM Textbook of Judo From USA Make check or M/O in the total amount of $34 (Shipping fee included) payable to N. Ogasawara. From Canada $45 (US Dollar) From other countries $58 (US Dollar) Name __________________________________________________ Tel. ( ) ________ ___________ E-Mail ________________________________________________________________________________ Address Street number & name __________________________________________________ City __________________________________________ State ___________________ Zip ___________ Country _________________________________

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Order_form_TX_2012

Transcript of Order_form_TX_2012

Page 1: Order_form_TX_2012

Send to:

N. Ogasawara

128 Sparrow Dr.

West Henrietta, NY 14586 USA

ORDER FORM Textbook of Judo

From USA Make check or M/O in the total amount of $34 (Shipping fee included) payable to N. Ogasawara.

From Canada “ $45 (US Dollar) “

From other countries “ $58 (US Dollar) “

Name __________________________________________________ Tel. ( ) ________ ___________

E-Mail ________________________________________________________________________________

Address

Street number & name __________________________________________________

City __________________________________________ State ___________________ Zip ___________

Country _________________________________