ANNE E. DECHANT MERCHANDISE MAIL-ORDER FORM

(Use for ordering merchandise by check or money order only)

All prices listed include shipping and handling.
C. SECCOND CLASS CITIZEN T-SHIRTS -

$20.00 each + $2.50 ship/handle

or TWO for $30.00 + $3.00 ship/handle

1. STYLE _______________________ Size _______ Quantity ________

QUANTITY___ X $22.50 = TOTAL______

2. SECOND CLASS CITIZEN T-FOR- TWO:

T-SHIRT ONE:

STYLE ______________________: Size _______

T-SHIRT TWO:

STYLE ______________________: Size _______

Additional order. SECOND CLASS CITIZEN T-FOR- TWO:

T-SHIRT ONE:

STYLE ______________________: Size _______

T-SHIRT TWO:

STYLE ______________________: Size _______

Number of sets T-forTWO:___ X $33.00 = TOTAL______

TOTAL OF SECTION C: ___________

A. CD's

1. CD: POP THE STAR

QUANTITY__ X $16.49 = TOTAL______

2. CD: LIVE! AN EVENING WITH ANNE E. DECHANT

QUANTITY__ X $13.99 = TOTAL______

TOTAL OF SECTION A: ___________
B. BUMPER STICKERS - Second Class Citizen

1. STICKERS: SET of SIX for $5.75

QUANTITY (OF SETS) _____X $5.75 = TOTAL _______

TOTAL OF SECTION B: ___________
GRAND TOTAL: A___________ +B ___________+ C ___________ = ______________*

SHIPPING ADDRESS: NAME: ________________________________________________________________

STREET: ___________________________________________________________ APT/UNIT # ___________

CITY: _____________________________________________ STATE: ___________ ZIP: _______________

*Make CHECK or MONEY ORDER made payable to FUNNYMAN MUSIC LTD, and mail it along with a copy of this completed form to: FUNNYMAN MUSIC LTD, PO BOX 770998 CLEVELAND, OH 44107

THANK YOU FOR YOUR PURCHASE! WE KNOW YOU WILL ENJOY YOUR SELECTIONS!

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