BrainDance.com T-shirt Order Form

Fill out and mail the form below with check enclosed to:

   BrainDance.com
   1075 Bellevue Way NE, #161
   Bellevue, WA 98004.

Your Name:
Your Company:
Email Addr:
Address:
Address2:
City:	State:
Zip:	Country:
Shirt Size (M/L/XL):

Check if this is an international order.

Catalog Item Qty Unit Price

BrainDance.com T-shirt $14.95

Brain Dancing Book (ISBN: 0964626004) $19.95

Brain Dancing Audiotape $14.95

StartGen Registration* $29.00

Subtotal $

8.6% Sales Tax (WA residents only) $

Shipping $

Total Due $

Catalog Item	Qty	Unit Price
BrainDance.com T-shirt		$14.95
Brain Dancing Book (ISBN: 0964626004)		$19.95
Brain Dancing Audiotape		$14.95
StartGen Registration*		$29.00
Subtotal	$
8.6% Sales Tax (WA residents only)	$
Shipping	$
Total Due	$

Shipping charges are calculated as follows: Domestic orders: $4 for first item and $1 for each additional item (There are no shipping charges for StartGen). International orders: $15 for first item and $3 for each additional item.

* There are no shipping charges for StartGen so don't count it as an item when calculating shipping charges.