| KN PRODUCTION ORDER FORM | ||||
| Fax toll free to: 1-877-773-4698 or mail to address at the bottom | ||||
| ITEM | Quantity | Price | Total | |
| VHS, English - It’s A Noisy World | $99.00 | |||
| VHS, Spanish - It's A Noisy World | $99.00 | |||
| VHS, English - 2 hr. tape It’s A Noisy World | $199.00 | |||
| VHS, Spanish - 2 hr. tape It's A Noisy World | $199.00 | |||
| VHS, English - Noise Destroys Your Hearing | $129.00 | |||
| VHS, Spanish - Noise Destroys Your Hearing | $129.00 | |||
| VHS, English - 2 hr tape Noise Destroys Your Hearing | $199.00 | |||
| VHS, Spanish – 2 hr tape Noise Destroys Your Hearing | $199.00 | |||
| VHS, English - Always Protect Your Hearing | $129.00 | |||
| VHS, Spanish - Always Protect Your Hearing | $129.00 | |||
| VHS, English - 2 hr. tape Always Protect Your Hearing | $199.00 | |||
| VHS, Spanish - 2 hr. tape Always Protect Your Hearing | $199.00 | |||
| DVD, English and Spanish Noise Destroys Your Hearing | $199.00 | |||
| DVD, English and Spanish Always Protect Your Hearing | $199.00 | |||
| Subtotal: | ||||
| * Colorado residents ONLY add 3% sales tax | Tax: | |||
| Shipping: | ||||
| SHIPPING/HANDLING COSTS | ||||
| United States $10 | ||||
| TOTAL: | ||||
| SHIP TO: | ||||
| Name | ||||
| Address | ||||
| City, State, Zip | ||||
| Phone (required) | ||||
| Fax (required) | ||||
| Email (required for shipping confirmation) | ||||
| BILL TO: r same as above | ||||
| Name | ||||
| Address | ||||
| City, State, Zip | ||||
| Phone (required) | ||||
| Fax (required) | ||||
| PAYMENT METHOD (circle one) | ||||
| VISA - Mastercard - American Express - Enclosed Purchase Order (call for authorization) | ||||
| Enclosed Check - COD | ||||
| For Credit Cards: | ||||
| Name on card: | ||||
| Card number: | ||||
| Expiration date and verification number (3 or 5 digit #): | ||||
| Amount Authorized: | ||||
| Signature: | ||||
| KN Production - 17500 E. Tennessee Place, Aurora, CO 80017 | ||||