The Whole Truth™ - Order Form

801 Fletcher's Ln.
Arrington, VA 22922
(434) 263-6336

SHIP TO:
Name:
Address:
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Telephone: () -
E-mail:

Billing Address (if different):
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Address:
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Description Quantity Price Total

Shipping & Handling

$9.99 and under $4.50

$10.00 - $49.99 $7.50

$50.00 - $99.99 $11.00

$100.00 - $199.99 $15.00

$200.00 and over $18.00

Shipping is Free on individual items over $100

For Shipping Outside the United States, please call.

Subtotal

Shipping & Handling

*Add'l. Gift to Support
The Whole Truth

Total

*We will receipt all donations, showing the fair market value of any materials received,
in order to help contributors determine the tax-deductible portion of their gifts.

My check or money order payable to The Whole Truth is enclosed.
Please charge my: MasterCard Visa Discover American Exp.
Card no. --- Exp. Date /
Signature_________________________________ 3-4 digit security number: