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PRINTABLE ORDER FORM

TEN TALENTS COOKBOOK
Frank J. Hurd, D.C., M.D.
Rosalie Hurd, B.S.
P.O.B. 5209, Grants Pass, OR 97527
Phone or Fax: 541-472-1113

Customer:

First Name:    Last Name:   
Address:
City: State:       Zip:   
E-mail: Phone:   

Ship to (if different than above):

First Name:    Last Name:   
Address:
City: State:       Zip:   

  Please enclose a gift card         Send information on wholesale discounts
Payment: Check   Money Order   Cash   Credit Card # 
Exp. Date:     Signature of Card Holder:____________________________
Quantity Item Total Price
   
   
   
   
   
   
Shipping & handling:    
Enclosed is a check, money order (U.S.), or credit card info.    Total:    
Mail to: Ten Talents, P.O. Box 5209, Grants Pass, Oregon 97527 USA
URL: http://www.tentalents.net   To E-mail: