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Lotus Video Productions

Order Form

  • Please fill out the form and print it.
  • Fields marked with * are required. Please remember, if you do not fill in all of the fields we can't send you your order.

*Ordering Info

*Episode #

*Description

*Qty.

*Price

*Subtotal

*Order total:

INSIDE THE U.S. - Please add $5.00 per tape for shipping and handling.
OUTSIDE THE U.S. - Please add $7.00 per tape for shipping and handling.

*Shipping:

*Total:

*Method of Payment

All checks are held for 10 days

Check

Money Order

International M.O.

Shipping & Contact Info

*Full Name:

*Address:

*City:

*State:

*Zip:

*Country:

E-mail:

*Phone:

Special Instructions:

REMEMBER
After filling out this form, print it out and send it with your payment to:

Joseph P. Rebelo II
c/o Rebelo's Kenpo Karate
147 Union Street
New Bedford, MA 02740-6365

1 hour specials: regularly $50. ON SALE for $40!

ONLY 25 copies of each episode will be produced, once these 25 are sold, no more will be available.

Each tape is $25 plus shipping and handling.
(priority mail and delivery confirmation)

Lotus Video Productions | Video List | Order Form

To contact us:

Phone: 508-999-2775
Email: KENPOJOE@aol.com