Form For Endorphin Rush II DVD

Price of DVD….$12 each (including postage to address in Singapore)

Name: __________________________________________________

Address to which DVD is to be posted: 

________________________________________________________

________________________________________________________

________________________________________________________

Number of copies: _________________________________________

Amount paid: _____________________________________________

Payment by:  Cheque (Payable to “Elizabeth Poey”)

To order by post, please send completed form with cheque to:

Liz Poey

MacPherson P O Box 1025,

Singapore  913410

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Received ____________ (please insert amount),

from _______________________________ (please insert your name)

                                                                                         Elizabeth Poey