Please provide your First and Last name*
Full Mailing address (Street, City, State, & Zip)*
Amount paid and method of payment. Make check payable to RJIA, P O Box 721713 OKC, OK 73142.*
How will you pay? Paypal, CashAPP, Zelle, Check? Your purchase amount will appear in the cart on the upper right hand corner.*
Referral name if applicable