* * * *
INTERNATIONAL ORDERING INFORMATION:
Canada, Mexico, Central and South America: add $2 shipping and handling.
All other countries: add $3 shipping and handling.
Payment must be made by check drawn in U.S. funds or an International Postal Money Order drawn in U.S. funds. NO CASH PLEASE!
* * * *

Name:___________________________________
Address:__________________________________
City:_____________________________________
State or Province:_____ Country:___________ Zip:_______
Phone#:(____)__________ Email:______________

ORDER INSTRUCTIONS:

1.) Print this form and fill it out
2.) Write a check/money order for the appropiate amount payable to: Upstart LLC
3.) Send the order form and check/money order to:

Thank you for your order!