| Ordered by: | Ship To: |
| Email: | |
| Phone: |
| Ordered by: | Ship To: |
| Email: | |
| Phone: |
|
Recording |
Price |
Qty |
Total |
| Irish Dream | $19.95 |
$ | |
|
Colorado Residents Add 2.9% Sales Tax |
$ | ||
|
Shipping and Handling ($2.50 for the first item; $1.00 for each additional item) |
$ | ||
| TOTAL REMITTED |
$ | ||
Print the order form, fill out completely and mail to:
11605 W. 73rd Avenue,
Arvada, Colorado 80005.Make check or money order payable to Field of Daisies, Inc. or fill in the credit card information (Visa or MasterCard only) below:
Credit Card Number:_____________________ Expiration Date:________
Signature:________________________________________Print Name on Card :________________________________________