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Video Order Form
Please print this form to place your order
 
Shipping Information
Name___________________________________
 

Address_________________________________
 

City________________________  State_______
 

Zip/Postal code______________________e-mail_______________________

Please include your e-mail address. You will be notified when your order was received and processed.


Payment method:  ____cash  _____check  ____ money order
Order Information
 
 
Quantity
Item
Description
Price
Total
.
2Pac Video
Uncut/Live
 . .
.
MC Breed Video
Concert
 . .
. . .
Subtotal
 .
 
 
Shipping/Handling
FREE
If outside U.S.
5.00
Total Amount Due .

 Mail completed form with payment to:

J. Meloy
1533 Jane Ave #1
Flint, Michigan 48506