"ForevaXena . . . Merchandise"
ORDER FORM

*Checks and Money Orders accepted*
(Checks must clear bank before item(s) ships)

Please allow 2-3 weeks for shipping - an email confirmation will be sent to you upon receipt of order.

NAME  
STREET ADDRESS  
ADDRESS #2  
CITY, STATE, ZIP  
PHONE  
E-MAIL  
QUANTITY TITLE PRICE EACH TOTAL
  ForevaXena . . . Bumper Sticker - Black $5.00  
  ForevaXena . . . Bumper Sticker - White $5.00  
  Xena:  Warrior Princess Limited-Edition Match Set $12.00  
SHIPPING

2.00

GRAND TOTAL  


Please print this page (or copy info on another paper) and send with your payment to:

Cindy Tingley
c/o Tingley Web Creations
85 Industrial Road #15
Big Pine Key, FL 33043

If you have any other questions, please E-MAIL:  ForevaXena@forevaxena.com