ORDER FORM
Dick of Dickstinction Certificate:
  $24.95 - 5.00 discount     Each: $19.95     How many? ___     Total: $ ________
         
Gold gift tube:
                             Each:  $2.95     How many? ___     Total: $ ________
         
Postage and Handling (per tube, not per certificate):
         USA            Each tube:  $2.25
         Canada         Each tube:  $2.95     How many? ___     Total: $ ________
         Elsewhere      Each tube:  $5.50
If you want all your certificates mailed in the same tube, then enter 1.
(Most people will choose this option.) However, you may wish to order one
tube for each certificate. Likewise, each gold gift tube must each be mailed
in its own separate shipping tube.
         
GRAND TOTAL:                                              GRAND TOTAL: $ ________
         
NAME(S) ON CERTIFICATE(S):
         
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YOUR NAME AND SHIPPING ADDRESS:
         
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MAIL THIS FORM AND YOUR PAYMENT TO:

Jim W. / PhD Home Pages
PO Box 151365
San Diego CA 92175-1365
         
Finally, send me an e-mail so I'll visit my PO box promptly:
      phdtop@phdtop.com
Be sure to use the phrase "Dear Jim" in your letter.
(This puts your e-mail into a non-spam, high-priority mailbox.)