Name ___________________________________________     Date ______________
  Street ________________________________________________________________
  City ____________________________________ State _____  Zip Code ___________
  Phone ______________________________  FAX ____________________________
  Email ________________________________  Web Site _______________________
  
  PAYEMENT  [  ] visa  [  ] mc  [  ] check (payable to wendy saunders companies)
  card # ___________________________________________  exp date ____________
  Name on card _____________________________  Signature ____________________
  Amount $__________________ 
  Billing Address on Card (if different) _________________________________________