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MAIL ORDER PURCHASE FORM |
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Please Print,
Fill Out & Mail With Check or Money Order To: |
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Ornel Jiménez |
U.S. Dollars |
| "Ciclos" CD @ $10.00 x # _____ ordered = | $ ______ |
Plus shipping, $3 for up to 5 items / $5 for 6 or more items. |
$ ______ |
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$ ______ |
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Mandar los compactos / Ship Compact Discs To |
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Nombre / Name: |
______________________ |
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Dirección / Street Address: |
______________________ |
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Ciudad y Estado / City & State (Province) |
______________________ |
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País / Country |
______________________ |
| E-Mail : __________________ |
Telephone: _________________ |