Receive the gift of the VRIL Generator by check or money order, or International money order through the mail
please print this form, fill it out and mail with Check or Money Order to:

James G. Gavin
859 JFK Blvd. East
  
Weehawken, NJ 07086   USA

phone: 201-286-8934

upon receipt of your check, money order, or International Money Order you will be notified by email of the time of the shipment of the gift of the VRIL Generator to your address (receipt of VG is within 4 days) 

Name _________________________

E-mail ____________________ (important for notifications)

Street ______________________________ Apt.# _____

City _________________ State(province) ______

Country ____    Zip code ________

 
VRIL Generator and Lifetime Hollow Earth Circle Membership Fee $75.00   

(shipping of the gift of the VRIL Generator  free in the USA or International by priority mail)

International Orders:  please pay by International Money Order payable in US dollars

number of VRIL Generators/Memberships _______

        
total: $___________


Please make payment in US dollars by Check, Money Order or International Money Order

 

if you have any difficulties filling out this form or have further questions contact onelighta@yahoo.com

onelight.com