Name : _____________________________________________
Address : ___________________________________________
City : _______________________________________________
Prov./St. : __________________ P.C./Zip : ________________
Telephone : ____ - ____ - _______
| 1 ______, 4 ______, 5 ______, 6 ______, 7 ______, 8 ______, 9 ______, 10 _____, |
| 11 _____, 14 _____, 15 _____, 17 _____, 21 _____, 22 _____, 24 _____, 25 _____, |
| 26 _____, 27 _____, 28 _____, 29 _____, 30 _____, 31 _____, 32 _____, 33 _____, |
| 34 _____, 35 _____, 36 _____, 37 _____, 38 _____, 39 _____, 40 _____, 41 _____, |
| 42 _____, 43 _____, 44 _____. |
Tape Offering Quantity Total
$ 6.00 each _______ ________
Postage and Handling
1 - 5 cassettes - - - $5.00 \
6 - 10 cassettes - - $6.00 ________
11 or more - - - - - - $7.00 /
Donation ________
Total ________