*** PLEASE PRINT AND FILL OUT FORM ***
                
                   48TH INTERNATIONAL SIX DAYS TRIAL
                      AUTOGRAPHED DVD ORDER FORM


Name _____________________________________________________________

Address __________________________________________________________

City ____________________________ State ____  Zipcode_____________

Phone Number __________________  Email ___________________________


Price:  1st DVD = $20.00; each additional is $15.00. 
Free Shipping & Handling.    

                                        1st DVD @ $20.00 = $20.00
                                 
                       Additional DVD Qty _____ x $15.00 = $_____              

                                          Total enclosed = $_____ 

Make check or money order payable to JOHN PENTON.
US FUNDS ONLY PLEASE.  

Send form and check or money order to address below.  

John Penton
C/O Bill Smith
38236 N. Rickham Ct.
Westland, Mi 48186