New Skete Monks Video Order Form

This form may be e-mailed with or without credit-card information. To phone your credit-card information to Dr. Jeff, see bottom of form. Or you can load and print a postal mail order form to submit your order via the postal service.
To: Re:
Your real name:
Your e-mail address:
Select number of sets you wish to order: The appropriate retail sales tax plus a $5.00-per-order shipping charge will be added.
Enter shipping address:

Credit-Card Information (See below): If you do not wish to enter your credit card number, you may still e-mail your order by pressing the SEND button at the bottom of this form, and then phoning Dr. Jeff at 1 203 222-7979. Otherwise, enter your credit-card information below. Your charge will appear on your credit-card statement as a charge to Dr. Jeff's Broad River Animal Hospital.
Select credit card:

Your name:

Credit card number:

Expiration date (month/year, e.g., 06/98):

Check the information above and then press the SEND button:
Thank you!

Jeff Feinman, VMD
73 Lyons Plains Rd
Weston, CT 06883
1 203 222-7979

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Last modified at 10:50 AM on 1/10/98.

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