WORLD TANG SOO DO ASSOCIATION
709 Oregon Avenue
Philadelphia, PA 19148
215-468-2121
Fax: 215-336-2121
Email: WTSDA@aol.com

WORLD KI GONG CLUB
EQUIPMENT ORDER FORM

You can fill out this form online and then print it out using the print icon on your browser.
Or you can just print it out and fill it in yourself. Send this form along with a check to the address above.
Membership in the World Ki Gong Club must be current, before items will be shipped.

  Quantity Price Total
WKGC Video
Training tape (1 1/2 Hrs) 		$25.00
T-shirts:
  Color:
White I,II   Yellow III  
Blue IV,V   Red VI
   Size (Adult):
S   M   L   XL   XXL 		$15.00
Pants:
   Size (Adult):
1   2   3   4   5   6   		$15.00
Book: The Root of Chinese Qigong
By Dr. Yang Jwing-Ming 		$25.00
Ki Gong advertising: Out-door banner $150.00

Shipping and Handling
Minimum $5.00
Orders over $50.00 add 5%.

  Min. $5.00

Total**

    
Sold to:
Ship to:
 
 
Date:
Phone:
Rank:
Assoc. #:
Ki Gong Level I   II   III   IV   V   VI  

WTSDA Use Only

SHIPPING DATE: ___________________
SHIPPED VIA: ___________________
NO. OF PACKAGES: ___________________
   

** A check for the total amount must be enclosed with your order