- - - - - Please Print This Form and Mail It To Fish Tail Records - - - - -
Fish Tail Records

      PO Box 2561  ~  Iowa City, IA 52244  USA ~ 319- 338-3614 ~  www.catfishkeith.com ~ catfishkeith@catfishkeith.com
             Mail Order Form:                                                         QTY            TOTAL                                             

                                                                           SHIPPING $3.00  _____________
                                                                          (Outside of US & Canada $5.00)
                                                            IOWA SALES TAX  7%    ___________
                                                            (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) 

number:_______________________________________________________________ 

Expiration date (Mo/Yr): _________________________________________________
Name (as shown on card): ________________________________________________
Shipping Address:    _____________________________________________________
City, State, Zip:        _____________________________________________________
Country, Postal Code: ___________________________________________________
Phone / email:          _____________________________________________________

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