_______I would like to order ________copy (copies) of The Clinic Cookbook, Come & Dine at $15.00 each plus $3.00 postage each for a total of $18.00. ($8.00 postage outside the U.S.)
Ship to:
NAME:
ADDRESS:
CITY:
STATE & ZIP:
COUNTRY:

Payment Method:

VISA_____________ MASTER CARD_______________ CHECK________________

CARD NUMBER_________________________________________________________________________

EXPIRATION DATE ________/___________

Email request with information to: info@STclinic.com
Fax form to: (505)897-0991
or mail form to:
S.T.R.C., Inc.
5 Bisbee Ct. 109-238
Santa Fe, NM 87508

THANK YOU FOR YOUR ORDER!