Timberline Order Form
Field of Daisies, Inc.
11605 W. 73rd Avenue
Arvada, CO 80005
| Ordered by: | Ship To: |
| Phone: |
CD $19.95 TAPE $9.95
|
Qty |
Total |
||
|
CD TAPE |
$ | ||
|
SUBTOTAL |
$ | ||
|
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 the address above.
Make check or money order out to Field of Daisies, Inc. or
fill in the credit card information (Visa or MasterCard only) below:
Credit Card Number: ___________________________ Expiration Date: _______
Signature: ________________________________________
Home | Order Form | The Band | Words & Music | Jim Salestrom