What's In The Box?
• 1 Pair of Continueum™ Shoes
• $20.00 in Danny Blaq coupons for upcoming Danny Blaq apparel
• FREE Continueum™ desktop & wallpaper images on CD-ROM

Your Email Address First Name Last Name

Select Shoe Size (USA): Men 6 Men 6.5 Men 7 Men 7.5 Men 8 Men 8.5 Men 9 Men 9.5 Men 10 Men 10.5 Men 11 Men 11.5 Men 12 Men 12.5 Men 13 Men 13.5 Men 14 Women 6 Women 6.5 Women 7 Women 7.5 Women 8 Women 8.5 Women 9 Women 9.5 Women 10 Women 10.5 Women 11 Women 11.5 Women 12 Quantity x $155.00 USD (Shipping Included) = Total $

Select Shoe Size (USA): Men 6 Men 6.5 Men 7 Men 7.5 Men 8 Men 8.5 Men 9 Men 9.5 Men 10 Men 10.5 Men 11 Men 11.5 Men 12 Men 12.5 Men 13 Men 13.5 Men 14 Women 6 Women 6.5 Women 7 Women 7.5 Women 8 Women 8.5 Women 9 Women 9.5 Women 10 Women 10.5 Women 11 Women 11.5 Women 12 Quantity x $155.00 USD (Shipping Included) = Total $

Grand Total $

Your Payment Method: Money Order By Mail VISA Mastercard AMEX Discover AlertPay NetSpend *
Your DETAILED payment information will not be required until you get your invoice from me via email, where you will pay online in a secure encrypted connection.

MAIL Money Orders payable to:
Danny Blaq
1703 East-West Hwy., Suite 715
Silver Spring, MD 20910 • USA

I understand the above information will be kept private & not shared with any 3rd party, no SPAM or bulk E-mails will be sent to me.