Phoenix 2005 Conference DVD Order Form

Complete this information and submit it to Athena Leadership Center.  Our site is secured for credit card use.  Your order will be filled as soon as the DVD's are available.
 
NAME
MAILING ADDRESS:
CITY:
STATE OR PROVINCE:
POSTAL OR ZIP CODE:
COUNTRY:
HOME PHONE:
WORK PHONE:
FAX PHONE:
E-MAIL ADDRESS:
PLEASE INDICATE THE MAILING ADDRESS ON YOUR CREDIT CARD STATEMENT IF IT DIFFERS FROM YOUR MAILING ADDRESS NOTED ABOVE:

Video Pricing

$250 per set of DVDs
NUMBER OF DVD SETS ORDERED:
NUMBER OF PAL DVD SETS ORDERED:
SHIPPING AND HANDLING:
(PER SET - $20 US, $30 CANADA OR MEXICO, $40 EUROPE, $45 ALL OTHERS)
TOTAL VIDEO ORDER:
   
METHOD OF PAYMENT:
CREDIT CARD NUMBER:
EXPIRATION DATE:
NAME ON THE CARD: