VIDEO / BOOK ORDER FORM 
Order Today While Supplies Last!

* Denotes Required - Do Not Leave Space Blank

  First Name
  Last Name
  Address

  City
  State / Province
  Country
  Zip / Postal Code
  Daytime Phone #
  Evening Phone #
      E-Mail Address

Video Format                   VHS         DVD         PAL

Payment Method *          Check       Money Order      Credit Card 
   
* Make checks/money orders payable to "International Martial Arts Association"
* Outside of US, ONLY checks accepted are Travelers Checks
* If you are paying by check or money order, please send your  check or money order to the address at the bottom of this form, with VIDEO/BOOK ORDER in the memo space.  Your order WILL NOT be shipped until the check has cleared, but the materials you order WILL BE RESERVED FOR YOU at the CURRENT PRICE!


Credit Card Type
             Visa    MC    American Express 
Card Number                   
Expiration Date               
Month    Year 

      ITEM                                                               UNIT PRICE   QTY          TOTAL

VIDEO - 3 TAPE SET (Vol 1, 2 & 3)             ($99.99 US)        $

NEW-Single Video - Intro - Basic Techniques  ($39.99 US)        $

Single Video - Vol 1 - Beginner                          ($39.99 US)        $

Single Video - Vol 2 - Intermediate                    ($39.99 US)        $

Single Video - Vol 3 - Advanced                         ($39.99 US)        $

Book - One Step Manual                                   ($14.95 US)        $
                                                                                    ____________________________

                                                                                           SUBTOTAL     $  *

                                                 NJ Residents Add 6% Sales Tax                    

                                               Shipping & Handling (See Below)                       *
                                                                                    ____________________________
                                                                                                   TOTAL      $  *

Shipping & Handling (Inside US)
     1 Video   -      $   5.00
     2 Videos  -      $   8.00
     3 Video Set - $ 10.00
        4 Videos  -      $ 12.00    
     Manual -        $   3.00
Outside of US, double the US Shipping/Handling Rate

ADDRESS TO SEND CHECKS / MONEY ORDERS:
International Martial Arts Association
560 South Evergreen Ave.
Woodbury, NJ 08096, USA

Phone: 856-848-2333
Fax:     856-848-7399