Order “the Smiling Universe” Limited Edition print
and Visualization Audio CD Package

"The Smiling Universe" Limited Edition (Vibrant, full-color glossy print and Audio CD package)

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FAX this form to 1-267-543-4908

___ Enclosed is my check, money order or credit card order for $47.00 or $25 depending on which option I choose - plus $10 S&H ($20 foreign orders). The posters will be rolled and shipped in long tubes.

Totaling $_____________.00

Charge my (Note: You can use more than one card to complete this order):

Visa, Mastercard

Card Number:_____________________________________________ Exp. Date:______________

Signature: __________________________________________

Print Name: _______________________________________________________________________

Address 1: _________________________________________________________________________

Address 2: _________________________________________________________________________

City: ______________________________________ State: __________________________________

Zip Code: ______________________________ Country: __________________________________

Date of Birth: _____________________________________

Telephone: _______________________________________________

Fax Number: _____________________________________________

E-Mail: __________________________________________________

Or Mail This Order Form To:

Palko Publishing
7051 Ramblehurst Dr.
Sylvania, OH 43560

You may call our 24-Hour Order Line at: 1-877-375-4163 to place your order.