RXbot Order Form
Your Name_____________________________________________
E-mail______________________________________
Product being purchased_______________________________________________
Price______________________________________________
Aomunt Enclosed____________________________________________
Type of payment enclosed    [ ]  Check     [ ]   Bills   (No coins please, they rip the envelope)
  Send to: P.O. Box 1941, Richmond, Virgina 23218 
Make checks payable to Grant Fowler. 

Product type:   [ ] Bot   [ ] Item  [ ] Powerleveling  [ ] Donation
Paypal E-mail (If extra money is enclosed) ______________________________