| 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: Diane Renay - 670 Eldorado Lane - Las Vegas, NV 89123 | |||
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(Check box for Photo Ordered) |
Autograph to: |
(required) | |
|
Photo 1 q |
$10.00 (U.S. Dollars) includes
S&H |
Total: $10.00 | |
| $13.00 (U.S. Dollars)
includes S&H Outside U.S. & Canada |
Total: $13.00 | ||
|
Name: _____________________________ | |||
| Photo 2 q | $10.00 (U.S.
Dollars) includes S&H U.S. & Canada |
Total: $10.00 | |
| $13.00 (U.S. Dollars)
includes S&H Outside U.S. & Canada |
Total: $13.00 | ||
|
Name: _____________________________ | |||
| Photo 3 q | $10.00 (U.S.
Dollars) includes S&H U.S. & Canada |
Total: $10.00 | |
| $13.00 (U.S. Dollars)
includes S&H Outside U.S. & Canada |
Total: $13.00 | ||
|
Name: _____________________________ | |||
|
(Check box to order Double CD and free autographed photo |
Autograph to: |
(optional) | |
|
Double CD and free autographed photo q |
$ 15.00 (U.S. Dollars) per CD - includes S&H anywhere in the world. |
Total: $15.00 | |
|
Autograph CD to: (optional) Name: _____________________________ | |||
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Autograph photo to: (required) Name: _____________________________ | |||
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Enter Total Amount for items ordered ----Total = |
$ ___________ | ||
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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: _____________ | ||
