Karl Stephens Pacific Northwest Inc.

Fax order page (PRINT THIS AND FAX IT) to (360)-883-5669

Please complete the following form. Note for security purposes the billing information supplied must exactly match that which appears on your credit card bill. Shipping information need only be supplied when the shipping and billing addresses are different. All orders must have a $5.00 shipping and handling charge for 1- 2 disks. You will receive Email or Telephone verification of your order within 12 hours.

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Billing Information

Name on Credit Card

Company

Billing Address

City, State, Zip Code

Daytime Telephone

E-Mail

Shipping Information

Name

Company

Shipping Address

City, State, Zip Code

Daytime Telephone

Credit Card Information

Type of Credit Card

Credit Card Number

Expiration Date

Circle the movies you are ordering

2004 Introduction to Wind sports DVD ----------------$29.95

2005 How we Climb Mt. Adams DVD ------------------$25.00

2003 How we Climb Mt. St. Helens DVD -------------$25.00

2005 Day Hikes on Mt. Hood DVD coming soon ---------$00.00

DVD orders are shipped USPS Priority mail the day after the order is received.

All orders will have a $5.00 shipping and handling charge for 1- 2 disks. Orders for multiple quantities or those that require faster service should contact the Karl Stephens Pacific Northwest Inc. order desk 9:00 a.m. to 5:00 p.m. West Coast Time, Monday through Friday at (360) 601-1704

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Telephone Orders

Phone orders may be placed 9:00 a.m. to 5:00 p.m. Use this form.

West Coast Time, Monday through Friday by calling (360) 601-1704 Phone orders must be paid by Visa, MasterCard or American Express.

Contact Information

The staff of Karl Stephens Pacific Northwest Inc. is always interested in hearing from current and prospective clients. Staff may be reached 9:00 AM to 5:00 PM, Monday through Friday.

Telephone

(360) 601-1704

Fax (360)-838-5669

Postal address

Karl Stephens Pacific Northwest Inc.

PO Box 87157

Vancouver, WA 98687-87157