Michelle Kinkaid's Video Order Form Print out this form and send with CC info or check/money order to: Michelle Kinkaid, 671 Athens Street, San Francisco, CA 94112-3530 (You may also fax or email with credit card info - secure fax location) Tel/Fax: (415) 585-6282, Email: [email protected]

Name Shipping Address City, ST, Zip Phone Email Visa/MC# Credit Card Expiration Date: 3-digit code on back of card: Billing Address City, ST, Zip Check # Signature

Order Qty DVD Title #WCS-1 WCS Beginning/Intermediate #WCS-2 WCS Technique & Styling #WCS-3 WCS Syncopations & Styling (Int) #WCS-4 WCS Advanced #WCS-5 WCS Popular Variations 1 (Int) #WCS-6 WCS Popular Variations 2 (Int) #WCS-7 WCS “Fun” Int/Adv Variations #WCS-8 WCS “Outside The Box” (Int/Adv) #NC2-1 Night Club Two Step (Beg/Int) #HUS-1 Hustle (Beg/Int)

Total Quantity # @ $ each = USD $ California Residents add 9.5% Sales Tax = USD $ Shipping & Handling = USD $ Total Order Amount = USD $ Date

No Refunds. Exchange for same item only if defective.

Pricing & Policy (in US Dollars) Only $34 each for 1 or 2 items, $30 each for 3 or more items plus shipping and handling of $4 for the first item and $2 for each additional item. (USA locations only; other locations at additional cost) California residents add 9.5% Sales tax* (Sales Tax rate increased as of 4/1/09) *[e.g. for one item: $34 + 9.5% CA tax ($3.23) + $4 S&H=$41.23]

DVD Note: Our DVD's are produced in the DVD-R format which will play on most DVD players. Please advise us WITHIN 30 DAYS of any problems with a DVD. We also ask that you try the DVD in another player before you contact us. If the DVD still does not play properly, we will exchange it for another DVD of the same title.

04c0f8bc3b2607f2040eca9758e09525.doc 5/8/2018