ADDRESS     ________________________________________________________

CITY     ____________________________________________________________

STATE     _________     ZIP     ___________________     DAY PHONE     _______________________________

PAYMENT METHOD

  ENCLOSED IS MY CHECK OR MONEY ORDER PAYABLE TO GOLDINHANDS
  CHARGE TO MY CREDIT CARD.
              VISA                 MASTERCARD

CARD NUMBER     _____________________________________________     EXPIRATION DATE     ___________

CARD HOLDER'S NAME     ___________________________________________

SIGNATURE     ____________________________________________________

              SUBTOTAL   __________ 

POSTAGE & HANDLING    __________ 

TOTAL ORDER AMOUNT  __________