Exclamation Red Order Form
Simply print, fill out, and send this order form to the address below with check or money order made payable to Dan Patton.

name:
____________________________________________________
last...................................first

mailing address:
__________________________________________________________________
street......................city.........................state

item:

three short months compact disk..............quantity______

totals:

Each CD costs only seven dollars. Unfortunately, since you are using mail order, we have to cover our shipping costs. You're total charge is nine dollars. Send this filled out order form and check, money order, or well conceiled cash to:

exclamation red headquarters
3902 sandpiper ct n.
valparaiso in, 46385