Paul Wood CD - Printable Mail-In Order Form

SHIPPING INFO		BILLING INFO (fill in only if different)
Name	____________________	Name	____________________
Address	____________________	Address	____________________
Address	____________________	Address	____________________
City	____________________	City	____________________
State	____________________	State	____________________
Country	____________________	Country	____________________
Zip	____________________	Zip	____________________
Phone	____________________	Phone	____________________
Email	____________________	Email	____________________

PURCHASE INFO
CD		Qty	Price Ea.	Total
PIRATE RADIO - CD		____	$12.00ea	$______
BLUES IS MY BUSINESS - CD		____	$12.00ea	$______
THE BRIDGEBURNER - CD		____	$12.00ea	$______
		Subtotal		$______
		Shipping & Handling		$______
		GRAND TOTAL		$______

Make all checks payable to: Paul Wood
Mail this completed form along with your check or postal money order to:
Lucy Records, P.O. Box 13111, Oakland, CA, 94661