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Messianic Dance International - Order Form

You may order these materials by adding selected items in the form below and printing it, then mailing it along with your check to Messianic Dance International 7935 136th Avenue SE, Newcastle, WA 98059.

This form is designed to work in Microsoft Internet Explorer and should calculate the totals for you. If you experience problems with this form please goto our Original Order Form and fill it out manually, thanks. If you have any questions, please call MDI at (425) 793-3004.

Ship To:
Name
Address
City State Zip
Country Phone


Payment By:
Payment must accompany order. Sorry, our discount prices don’t permit billing or COD. We cannot accept payment by stamps. Overseas customers, your payment must be in U.S. funds from a U.S. bank. If you pay with a credit card, your bank will calculate the amount based on the current exchange rate for you.
Check/money order MasterCard VISA Discover Novus
Credit Card Number   Expiration Date (mm/yy)
Please be sure to include the digits in the metallic portion of your card.

Signature of Authorized Buyer: _______________________________________


QuantityItemMediaTotal
Subtotal 
Discount 
Weight 
Postage 
Total 


MDI is obligated by law to track and report the duplication of any video recordings, sound recordings and study guides to the entities who gave us permission to use them. These materials cannot be copied or duplicated by any means for any purpose. To receive your order, sign the statement below that acknowledges to us and to these entities your agreement to uphold the integrity of the copyright law that secures these materials.

I will not copy or duplicate the tapes or study guides produced by Messianic Dance International for any purpose.

Signed______________________________

Messianic Dance International
7935 136th Avenue SE, Newcastle, WA 98059
Phone (425) 793-3004, Fax (425) 793-3003
Email: mdi@BeitTikvah.com