| Print this
form. Then, fill out the
form to order your Diane Renay CD and Photo(s). Allow 4 to 6 weeks for
delivery. "Autograph to" MUST be
entered.
Autograph on CD is optional. Please make check or money order (IN U.S. DOLLARS ONLY) PAYABLE TO "Renee Eagan" and mail to: Diane Renay - 670 Eldorado Lane - Las Vegas, NV 89123 | |||
|
(Check box for Photo Ordered) |
Autograph to: |
(required) | |
|
Photo 1 q |
$15.00 (U.S. Dollars) includes
S&H |
Total: $15.00 | |
| $18.00 (U.S. Dollars)
includes S&H Outside U.S. & Canada |
Total: $18.00 | ||
|
Name: _____________________________ | |||
| Photo 2 q | $15.00 (U.S.
Dollars) includes S&H U.S. & Canada |
Total: $15.00 | |
| $18.00 (U.S. Dollars)
includes S&H Outside U.S. & Canada |
Total: $18.00 | ||
|
Name: _____________________________ | |||
| Photo 3 q | $15.00 (U.S.
Dollars) includes S&H U.S. & Canada |
Total: $15.00 | |
| $18.00 (U.S. Dollars)
includes S&H Outside U.S. & Canada |
Total: $18.00 | ||
|
Name: _____________________________ | |||
|
(Check box to order CD and free autographed photo) |
Autograph to: |
(optional) | |
|
Double CD and free photo q |
$ 15.00 (U.S. Dollars) per CD - includes S&H anywhere in the world. |
Total: $15.00 | |
|
Autograph CD to: (optional) Name: _____________________________ | |||
|
Autograph photo to: (required) Name: _____________________________ | |||
|
Enter Total Amount for items ordered ----Total = |
$ ___________ | ||
|
First Name: ___________________ |
Last Name: _____________________ | ||
|
Phone: |
_______________ |
Email:_________________________ | |
|
Submit e-mail address if any to be contacted if necessary. | |||
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Address: ________________________ |
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City: ____________________________ |
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State:___________________________ |
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Zip: _______________ |
Country: _____________ | ||
