CD America Project
Produced by Judy Lamppu

America Speaks from the Heart
Order Form (Click here to Print)

Your Name ____________________________________________

Company _____________________________________________

Address ______________________________________________

City _______________________ State ________ Zip __________

Telephone _____________________ Fax ___________________

Email and/or Website ____________________________________

How did you hear about America Speaks from the Heart?

_____________________________________________________

How many CDs do you want to order? xxx _______________

How are you paying? xxx (circle one) xxxx check xxxx credit card

Quantity of CDs xxxx $ ___________x $16 first CD; $14 each add'l

CA Sales Tax xxxxxx $ ___________ x 8.25% (CA residents only)

Shipping xxxxxxxxxxx$ ___________x $3 first CD; $1 each add'l

TOTAL ORDER xxxx $ ___________

If you are paying by credit card, please provide:

Name of Card _________________________________________

Card No. ________________________________ Exp. ________

Signature ____________________________________________

...end of order form