| ORDERED
BY: |
| Name: |
.
|
| Street
Address: |
.
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| City,
State, ZIP: |
|
| Phone
Number: |
.
|
| Email
Address: |
.
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| Description |
Quantity |
Total
Price |
| |
|
|
| Shoshanna
In Performance, vol. 1 |
|
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| |
|
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METHODS
OF PAYMENT
Please
DO NOT send cash.
Send Check or Money Order.
Wholesale
Prices available upon request
|
SUBTOTAL |
|
|
Shipping
- $4.00
(for
up to 4 videos) |
|
| |
|
TOTAL
ENCLOSED |
|
Please
mail this form (or the information requested above) along with your
check or money order made out to SHOSHANNA to the following address:
P.O. Box 1038
Arcata, CA 95518
|
