Mail Order Form

Instructions: Please print this form, fill it out clearly and completely, and mail it back to us. Please enclose a check, cashier's check, or money order in US or Canadian funds PAYABLE TO MICHAEL HUGHES. 

Mail to:

MICHAEL HUGHES
1846½ N. Kingsley Dr., Suite 1
Los Angeles, CA 90027
U.S.A.

I have read and I agree to your order policies found at www.thebirthdaycd.com/buy1.htm (or for international orders, at www.thebirthdaycd.com/Buy_International_Policies.htm): ________(initial if agreeing--we cannot process your order without your initials).

I am ordering [       ] copies of The Birthday CD, each copy at US$10.95, for a total product price of [$            ]. Shipping and handling is $3 + 95¢ per each CD for orders shipped to the US, its possessions, and Canada [Elsewhere in the world: $5 + $1.95 per CD], for a total shipping & handling charge of [$            ]. If this order is shipped to a California address, I realize that I will be charged sales tax at 8.25% of the product price (not on the shipping & handling), for a total sales tax charge of [$            ]. My total order therefore comes to [$              ].

Email:____________________ Tel:__________________  Fax:________________

Ship To Address (write clearly):

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Check or Money Order/Cashier's Check Enclosed