Order Form

For U.S. & International Residents only.

contact information and mailing address

Last Name:  
First Name:  
Name of Business:  
Mailing Address:  
City:  
Province / State:  
Country:  
Postal / Zip Code:  

Home#  Area Code:   Number:  
Fax#     Area Code:   Number:  

Work#   Area Code:   Number:  
Fax#     Area Code:   Number:  

E-mail Address:  

Preferred method of communication:  E-mail Telephone (Home) Telephone (Work) Fax (Home) Fax (Work)

products you wish to order

videos:

Meridian Shiatsu $10 + $6 S&H =$16.00 out of stock Shiatsu Stretching $20 + $6 S&H = $26.00 out of stock Meridian Shiatsu & Shiatsu Stretching $40 + $12 S&H = $52.00 none


           
           

                                                                                                                                                   Subtotal A      
                                                            Shipping & Handling B       
                                                                         

                                                                         TOTAL (A+B)      

Method of Payment:  Visa MasterCard

Card Number: 
Expiration Date: 

If you do not feel comfortable giving your credit card information 
over the internet please do one the following:

Type FAX beside "Method of Payment". 
Submit form and fax your credit card information to (416) 323-1681.  
or
Type PHONE beside "Method of Payment". 
Submit form and phone us with your credit card information 
at (416) 323-1818 or toll-free (800) 263-1703 (U.S. calls only) 

If you do not have a VISA or MasterCard please do not send a 
personal cheque or cash: 

Type N/A beside "Method of Payment". 
Submit form and we will contact you regarding an alternative method of payment.

 Please allow 4-6 weeks for delivery.