ULTIMATE NAME CHANGE KIT - MAIL IN ORDER FORM

You may print and use this form to send in a payment by mail. Please make checks payable to:

APC Entertainment Network, LLC - POB 110120 - Nutley, NJ 07110

ORDER INFORMATION:

Qty 1 Ultimate Name Change Kit $22.95 + $4.50 for shipping/handling= $27.45

SHIPPING INFORMATION:

Name: _______________________________________________________________________

Address: _____________________________________________________________________

City: ________________________________ State: _______ Zip: _______________________

Daytime phone number: __________________________

Email: _________________________________________

Which state would you like your kit specified for? _________________

Have you gotten married yet?   _____Yes   _____Not yet

All sales are final. We do not accept returns.

Thank you and congratulations!

Phone Inquiries & Orders: 973-320-2279

© 1997-2007 Wedding Zone / APC Entertainment Network, LLC. User Agreement

FORM 0406NC