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United States Groopad Order Form



Reply to and fill out this form by March 14th if you reside in the US.

Name/Handle:
E-mail:
Street Address:
State:
Country:
Zip Code:

Number of Groopad 1A (Groo & Rufferto) to order:
Number of Groopad 2A (color/monotone combo) to order:
Total number of Groopads:
Amount due in US funds [1) $12, 2) $19, 3) $26, 4) $32]:

Send US money order, US cheque, or US cash to be received by March 22nd
to:

Ruben Arellano
#306 - 1385 Draycott Rd.
North Vancouver, BC
Canada  V7J 3K9

PS:  Don't forget to include a return mailing label with your payment!