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Address
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  State Zip
Country     E-Mail

Daytime Phone 
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Ship To: (If different from above, e.g., for gift orders)

First Name
Last Name
Address
City
  State Zip
Country

Daytime Phone

Method of Payment

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Signature

Video tapes will be sent in the format standard of your country,  either NTSC or PAL. Sorry, we do not duplicate video tapes in the SECAM format.

ITEM QTY Price TOTAL
Sub-total

Shipping Charges

US and Canada Europe, Middle East, South and Central America Pacific Rim and Africa
$00-$11.99..........
$12.00-$25.99.....
$26.00-$35.99.....
$36.00-$50.99.....
$51.00-$99.99.....
$100.00-$200.99..
$201.00-$500.99..
$501.00 & up .....		 $ 2.50
$ 4.50
$ 6.00
$ 8.00
$10.00
$14.00
$21.00
$25.00 		$00-$11.99.........
$12.00-$25.99.......
$26.00-$50.99......
$51.00-$100.99....
$101.00-$200.99...
$201.00-$300.99...
$301.00-$400.99....
$401.00-500.99......
$501.00 & up.........		 $ 7.00
$10.00
$15.00
$20.00
$25.00
$35.00
$40.00
$45.00
$50.00 		$00-$11.99 ..........
$12.00-$25.99.......
$26.00-$50.99......
$51.00-$100.99....
$101.00-$200.99...
$201.00-$300.99...
$301.00-$400.99....
$401.00-500.99......
$501.00 & up.........		 $ 7.00
$10.00
$18.00
$25.00
$30.00
$40.00
$45.00
$50.00
$60.00
Shipping

 
TOTAL
(US funds only)

Special Instructions

Mail or Fax this Form

The Gangaji Foundation
2245 Ashland Street
Ashland, OR  97520

Phone
  800-267-9205
  541-482-3100
Fax
  541-552-9921
 

The Gangaji Foundation
2245 Ashland Street
Ashland, OR 97520, USA
Phone 541-482-3100, 800-267-9205; Fax 541-552-9921
E-mail:
For web-related issues:

All content copyright © 1999-2008 The Gangaji Foundation
 

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