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Response-O-Matic Form

RAC Marketing

Order Form

Just print out this form, complete all information and send with your money order or check payable to: Richard Stein. If you have any questions or would like your order seny COD, fill out the "Comments or COD Order Information" portions with you question or complete order information and click "Submit".

Name ____________________________________________________

Address ___________________________________________________

__________________________________________________

Phone ________________________ Date ______________________

Your name:
Email address:

Any comments or COD Order Information
Complete shipping information and phone number is nesseccary for COD orders($15.00 must be added to all COD orders)

abarich@yahoo.com

RAC Marketing • 7910 Treehouse Ln. Ste. 1131 • Dallas, TX 75231-3135

Your name:

Email address:

Any comments or COD Order Information