DVG America Order Form

ITEM

QUANTITY

PRICE EACH

TOTAL

SPORTS PASS BOOKS

 

$ 5.00

 

TRACKING CERTIFICATES

 

$ 1.00

 

OBEDIENCE CERTIFICATES

 

$ 1.00

 

GRAND TOTAL

 

 

Please make check or money order payable to DVG America

Your Name: _______________________________________________________

Street Address: _____________________________________________________

City, State, Zip Code: ________________________________________________

Amount Enclosed: ________________ Telephone Number: ___________________

Mail the order form with payment (in U.S. funds) to:

Sandi Purdy
DVG America/ LV Secretary
2101 Westmoreland Rd
Red Oak, TX 75154
(972) 617-2988