A&A Media Mail Order Form

 YOUR SHIPPING INFORMATION

   NAME          ______________________________________________

   ADDRESS    ______________________________________________

   CITY            ______________________________________________

   STATE         ______________      ZIP CODE   __________________

   CONTACT  EMAIL (Shipping Notification)  or PHONE NUMBER  (OPTIONAL)

    ______________________________________________

 

                         SHOW TITLES                                                                                                                             PRICE

______________________________________________  $ ______________

 ______________________________________________  $ ______________

 ______________________________________________ $ ______________

______________________________________________  $ ______________

                                                                                         SHIPPING  $ ______________   

                                                                                           TOTAL   $ ______________                                                                                       

 Shipping Prices for USA Only 

0 - $9.99 = 99 Cents
$10 - $49.99 = $5.99            
$50 - $199.99 = $6.99              
$200 and Up = $8.99            

 

PLEASE SEND CHECK OR MONEY ORDER 

 PAYABLE TO 'A&A MEDIA' TO: 

 A&A Media
10751 Sheridan Dawn Court
Henderson, NV 89052

U.S.A.