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Mail Order Form

Name: ________________________________________
Mailing address (to send order to): ____________________________________________________________
City: _____________________________________ State: ______________ Zip Code: __________________
Phone #: ______________________________ Email Address: ______________________________________

Item	Size/ Design (Checkmark to specify)	Quantity	Price per item	Total Price
Full-length CD (Preorder)			$12
5-Song CD			$7
Record Player Radio T-shirt	S___ M___ L____		$12
Promotional 8x10 Photo			$2
Stickers	White____ Blue____ Gray____ Red_____		$1.50
Buttons	Red Design______ White Design______		$1
			TOTAL:

All prices above include shipping and handling costs.
Print and send order form with check to:
Record Player Radio
19236 Live Oak St.
Hesperia, CA 92345
Make checks payable to Gilbert Hernandez.

Thank you for your orders!

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