(Click "file" and click print)

Diversified Marketing International 
Master Distributor                     Date __________ 
24 Pearl Street                        
Lewiston, Maine 04240-5646             Code #___________          
Voice or Fax (207) 786-8785
mailto:snowbear@tka.com

Order Form (mail with payment)

	ITEM DESCRIPTION 		      PRICE 	QTY.        TOTAL 

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						         Sub Total   ____________

				 Maine Residents add 5%  Sales Tax   ____________

				             Shipping - Please call  ____________

				   International S&H  -  Please Call ____________

						       Total Order   ____________

	            Name_________________________________________________

        Shipping Address_________________________________________________

   City, State, Zip Code_________________________________________________

              Country__________________ Day/Night Phone__________________ E-Mail________________

We accept credit cards via PayPal.
We accept cash, money orders, personal, business or Credit Card checks.