Order Form

JOYCE MEADOWS ORDER FORM

If you plan to mail a check or money order instead of ordering by PayPal, first email us your mailing address and what you want to order. We’ll email you back with cost and mailing information. Thanks!

Name: _________________________________________________________________

Address: _______________________________________________________________

City: __________________________________________________________________

State/Province: ______________________________ Zip/Postal Code: _______________

Country: ________________________________________________________________

E-mail address: __________________________________________________________

Phone: ________________________________ Fax: ____________________________

ITEM	PRICE	QUANTITY	TOTAL
SIGNED PHOTO SIGNED LOBBY CARD BRAIN FROM PLANET AROUS CD	$20.00 $24.00 $30.00
Sales tax (9.25% California residents only)
Shipping: Domestic: $5.00. International: $19.00
TOTAL

Payment method (circle one): check/money order Visa MasterCard

Credit card number: _________-_________-________-________ Expiration date: ___________

Signature: _________________________________________________________________


	Brain CD Order Form


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