Print this form and mail to: ** Be sure to include a check for the amount of your purchase. **
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MAKE CHECK'S PAYABLE TO: RFJ Music 2305 Darla Dr. High Ridge, MO 63049 |
| Item | Cost | Quantity | Your Cost | |
|---|---|---|---|---|
| Jordan's Creed "Steps" CD | $15.00 | x | $ | |
| Jordan's Creed autographed picture | $2.00 | x | $ | |
| Jordan's Creed bumper sticker | free | x | $0.00 | |
| Comments:
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Your total: | $ |
NAME: ______________________________________________________
ADDRESS:___________________________________________________
____________________________________________________
CITY:____________________________STATE:________ZIP:___________
PHONE:_______________________E-MAIL_________________________