To order, please print out this form and send with a check or money order payable to "Peter Moses."
Mail to: PJM, PO BOX 3, Flourtown, PA 19031

(United States & Canadian Orders Only)

SHIP TO:

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NAME

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STREET ADDRESS

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CITY

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STATE/PROVENCE                                           ZIP/POSTAL CODE

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PHONE (HOME)                               (WORK)

SHIPPING - 1st Class Regular US Mail (most orders ship within 48 hrs.)
100% GUARANTEE - If you are not completely happy with any purchase
for any reason, just return the item by UPS or insured mail within 30 days
for a prompt exchange or refund.

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