Mail-in Order Form

1-World Mail-in or Fax Order Form
(Print the form below or copy information and fax or mail with payment)
FAX # (206) 781-1401

ORDERED BY:		SHIP TO: (If Different)
Name:
Street Address:
City, State, Zip Code
Country
E-mail:
Telephone#
ITEM #	FILM TITLE	PRICE	QTY.	TOTAL
#	"	$		$
#	"	$		$
#	"	$		$
#	"	$		$
( ) Master Card ( ) Visa ( ) American Express Card#_______________________________________ Expiration Date (mo/yr): ____/_____ Cardholders Name:______________________________		Sub-total: S&H (See rates below) TOTAL		$
				$
				$
Shipping and Handling Charges: U.S. and Canada only. International Shipping:		$7.95 $1.00 $12.95 $14.95	1 Item Each Additional Item 6 or More Items 1-6 Items
Please make checks or money orders payable in U.S. funds to: 1-World LLC 1605 South Jackson Street Seattle, WA 98144
Your order will be processed within 5 days of receiving your check. Please allow 3-6 weeks for delivery.