The Crystal Chamber Healing Center
Printable Order Form

Please print order form and fill out completely. Make payment [Money Order or Cashiers Checks only] and send to:

Dr. Elizabeth A. King
6073 Dewberry Court
Las Vegas, NV 89110

**If you are ordering courses that require photocopy/xerox certificates [example: for Reiki Courses] please be sure to include those as well.

Your information is never sold, rented, or given to anyone ever - it used for internal purposes only. If you have any questions please contact the Crystal Chamber Healing Center at: crystalchambr@aol.com

PRINT CLEARLY
Name: ______________________________________________________
[** For Reiki Courses - How you would like your name to appear on your certificate(s)]

Address: ____________________________________________________

City, State, Zip: _______________________________________________

Country: ____________________________________________________

Phone Number: Daytime_____________________/Evening_________________________

Email Address: _______________________________________________

Qty: ___ Item:_______________________________________________ Price:_______
Qty: ___ Item:_______________________________________________ Price:_______
Qty: ___ Item:_______________________________________________ Price:_______
Qty: ___ Item:_______________________________________________ Price:_______
Qty: ___ Item:_______________________________________________ Price:_______

Sub-Total: ___________________
Shipping & Handling: ___________________
Total: ___________________

Shipping & Handling Cost Table:
$0.01 - 9.99: $5.00
$10.00 - 49.99: $7.00
$50.00 - 99.99: $9.00
$100.00 - 199.99: $9.00
$200.00 and over: $10.00

The Crystal Chamber Healing Center