The Master's Lip Reading Academy
Please Print out this page and mail to:
DAVID HARRISON
P.O. Box 3021
Chattanooga, TN 37404
423-624-1669
dmharrison1@juno.com
Mail In Order Form
Name _______________________________________
Address _____________________________________
City ______________________ State __________ Zip Code ___________
Home Number ( ) ____________ Cell Number ( ) _____________
Email Adress __________________________________
| Product Name | Price | Quanity | Subtotal | Shipping | Total Amount Enclosed |
|---|---|---|---|---|---|
| Pocket Talk Ultra |
$179.00 |
8.50 | |||
Ringmax Amplified |
$39.00 |
$8.50 | |||
| Teletalker Amplfied Telephone |
$149.00 | $149.00 | |||
| Lip Reading at Home DVD | $85.00 | $8.50 | |||
| Ototoxic Drugs Exposed | $35.00 | $8.50 | |||
| Keys to Successfully Living with Hearing loss | $14.75 | N/A | |||
| Total Enclosed | $ |
Please allow 4-6 weeks for delivery.