Offline Order Form

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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 for Diane Renay (IN U.S. DOLLARS ONLY) payable to "Renee Eagan" and mail to:
5854 Corazon Drive - Las Vegas, NV 89103

(Check box for Photo Ordered)

Autograph to:

(required)

Photo 1 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 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)

Autograph to:

(optional)

Double CD q

$ 15.00 (U.S. Dollars) per CD - includes S&H anywhere in the world.

Total: $15.00

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.

Address: ________________________

 

City: ____________________________

 

State:___________________________

 

Zip:  _______________

Country: _____________