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Lindsey Ridener
CD ORDER FORM:

 
    Qty.
 
 
1.Lindsey Ridener CD $10.00 [ ] ____  
Total no. of CD's
ordered @ $15.00 each
 
____  $________
NV sales tax
@ $1.09 per CD 
____  $________
Plus $3 for Shipping & Handling*
(*International orders will be extra)
 $________

TOTAL AMOUNT OF ORDER
 
 $________
   
PAYMENT METHOD:   __ credit card
__ check
__ money order
   
CREDIT CARD INFORMATION
Credit Card:   ___ Visa
___ Master Card
___ American Express
___ Discover
Name on Card:   ________________________
Card Number:   ________________________
Expiration:   MO:___________   YR:______
Ship to:

________________________
________________________
________________________
________________________


Phone: (       ) _________________
Make check or money order
Payable To:

Lindsey Ridener

 P.O. Box 902
Brownsburg, In.
                                   46112
(Please print your name & address clearly) Thank you!

By signing below I authorize this charge to my credit card

---------------------------------------------  Date------------------

PRINT THIS FORM & MAIL TO ADDRESS ABOVE 
OR FAX TO 317-272-0945
                            
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