Order Form

NAME: __________________________________________________________________

ADDRESS: _______________________________________________________________

________________________________________________________________________

________________________________________________________________________

Phone #: ___________________________________________

E-Mail: ___________________________________________________________________



Please Send Me:

__________ Short Range Strikes DVD @
 Price $24.95 EACH.

__________ 0 to Dangerous DVD @  Price $24.95 EACH.

Shipping $7.00 for up to 4 DVD's. Add $2.00 for each additional DVD.

Or Call: (757) 846-1188 for Credit Card orders!

MAKE CHECK OR MONEY ORDER PAYABLE TO:
MASS Martial Arts

Send Order form to:

MASS Martial Arts
5738 George Washington Memorial Hwy.
Yorktown, VA, 23692