| Please print this form, fill it out and sent it with a signed Check or Money Order to Kin H Chan 565 80th street apt 3F Brooklyn N.Y. 11209 |
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| Name ___________________________________________________ Address ___________________________________________________ City State ___________________________________________________ Zip Code E-mail Address ___________________________________________________ Phone # ___________________________________________________ |
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| Make all Checks or money order payable to Kin H Chan 565 80th Street apt 3F Brooklyn N.Y. 11209 Shipping Please use our shipping rate All video will take 6 to 7 business day after receiving payment. Thank you. Feel Free to Contract me at info@thehypno.com |
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