video order – The Duchess Fund

Print and complete this video order form and include it when you send your check or money order for
$59.95 (per video) made payable to The Duchess Fund to:

The Duchess Fund

408 – 14th Street S.W.

Ruskin, FL 33570

Quantity: __________

Name:
_________________________________________________________

Address:
_______________________________________________________

City, State, Zip Code:
____________________________________________

E-mail Address:
__________________________________________________

Phone:
_________________________________________________________

Sorry, no credit card
orders

Florida Residents add
6.75% Sales Tax or $4.05 – total $64.00 (per video)

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