Order Form:

Multi-Language Media, Inc.
PO Box 301
Ephrata PA 17522
(717) 738-0582 phone
(717) 738-9905 fax
email: mlminfo@multilanguage.com

Name:
Address:
City: State: Zip:
Telephone: Email:
Date:
Qty Item No. Title Price Total
         
         
         
         
         
         
         
         
         
         
         
         
         
         


Subtotal:
Postage and Handling
PA 6% Sales Tax*:
TOTAL:
(Please enclose payment with order
or fax order to 717-738-9905, giving a VISA or MASTERCARD number with expiration date and the three- digit code on the back of the card.)
*For sales In PA only  --  figure  tax on postage and handling as well.