FAX ORDER FORM

Download or print out this from, fill it in and fax it to:

DTP, Inc.
602-808-8635

Or, mail to:
DTP, Inc.
Box 3083
Stony Creek, CT 06405-1683 USA

NAME:___________________________________________________

ADDRESS:________________________________________________

PHONE:(    ) - ____ - _____

FAX:(    ) - ____ - _____

EMAIL:__________________________________________________

PURCHASE


        Pre/Postnatal Products:                                      no.   total$

Pre/Postnatal Health and Fitness Instructor's Manual.         $50 x ____ = ______


Dancing Thru Pregnancy/AfterDance t-shirt.                   $ 20 x ____ = ______



                                        CT residents add 6% sales tax     ______

                                          NY residents add local rate     ______


                                                                  TOTAL:  ______

Visa #_____________________________________ EXP.DATA___________________

Signature__________________________________ Today's Date_______________

Request for Information

I Would like to receive information concerning:

_____ Consumer Consultation service
_____ Qualified health & fitness educators in my area

_____ Continuing Education
_____ Instructor Training and Licensing

_____ Licensing and Program Development