BILL TO: Name: Street: City, State: ZIP: Phone: Email:	SHIP TO: Name: Street: City, State: ZIP: Phone: Email:
Payment Method:   __Check   __Money Order   __Credit Card		If credit card:   __Visa   __MasterCard Card #: ___________________________________ Expiration date (mo/yr): ________________ Signature: ___________________________________

ITEM	QUANTITY	PRICE	AMOUNT
Standing Stark: The Willingness to Engage Autograph: ___yes     Name:		14.95
Calling Our Spirits Home: Gateways to Full Consciousness Autograph: ___yes     Name:		14.95
Who Is Holding Your Reins? -- Audiotape, 90 minutes		12.00
Breath Meditations -- Audiotape, 60 minutes		12.00
NLP And The Spirit Path -- Audiotape, 90 minutes		12.00
Fine Art: Photo Name _____________ Size ___________ Color ___________		see price list*
Fine Art: Photo Name _____________ Size ___________ Color ___________		see price list*
Fine Art: Photo Name _____________ Size ___________ Color ___________		see price list*
		Subtotal
S&H:    Subtotal of $1-25, add $4.50 $26-50, add $5.50 $51-100, add $6.50 Over $100, Free shipping
Arizona residents please add 8.35% sales tax.
Please make checks payable to Kenosis. Thank you for your order!		TOTAL
Gift ____ Suggest an autographed message:
.
.
*Pricing for Fine Art Photos: Black & White               Sepia Toned               Hand Colored 5" X 7" -- $75               5" X 7" -- $85            5" X 7" -- $95 8" X 10" -- $95             8" X 10" -- $105        8" X 10" -- $125 11" X 14" -- $150         11" X 14" -- $165
TO ORDER You may call 928/778-1058; send a message to order@kenosis.net; print the form and fax to 928/636-3978; or print the form and mail to Kenosis, P.O. Box 10441, Prescott, AZ 86304.