DVD Order Form

Please fill out and mail in the form below.  Include your payment of Check (to Joe Marty), or Duluth grocery store gift Certificate  and send it to:

Joe Marty
521 N 17th Ave E
Duluth, MN 55811

Name:______________________________ Phone:_____________________

E-mail:______________________________________________

Mailing address (for shipping):________________________________________

________________________________________

________________________________________

Type	Price	Number	Total	
DVDs	$20		$	
Shipping	$2	(optional)	$	
Total cost			$	

VHS tapes are available by request for the same price.  Please indicate if you want VHS.

Picturelife | 218-343-1903 | 521 N 17th Ave E, Duluth, MN 55811
http://media.breezyandjoe.com