- -
- - - Please
Print This Form and Mail It To Fish Tail Records - - - -
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Fish Tail
Records
SHIPPING
$3.00 ___________
(Out
of US & Canada $5.00)
IOWA SALES
TAX 5% ___________
(Iowa
residents only)
TOTAL
AMOUNT ___________
(
) Enclosed is a USA check or money
order for the Total Amount (to Fish Tail Records)
( )Please charge the Total Amount to VISA /
MASTERCARD
(circle one)
Card
number:_______________________________________________________________
Exp date (Mo/Yr):
______________________________________________________
Name (as shown on card):
________________________________________________
Shipping Address:
_____________________________________________________
City, State,
Zip:
_____________________________________________________
Country,
Code:
_____________________________________________________
Phone / email:
_____________________________________________________