Order Form

Name:_____________________________
Address: _____________________________
              _____________________________
              _____________________________
   Phone: _____________________________
E-Mail: _____________________________

Shipment Address if other than buyer's address:

    Name:_____________________________
Address: _____________________________
              _____________________________
              _____________________________


Members Cost "California Blend" CD: Qty:_____ Total @ $17.40 each: $________ "Gospel Songs I Grew Up WIth" CD: Qty:_____ Total @ $13.80 each: $________ CLA Jacket Qty:_____ Total @ $144.00 each: $________ Size: Sm ___ Med ___ Lg ___ X-Lg ___ XX-Lg ___	Non Members Cost "California Blend" CD: Qty:_____ Total @ $19.00 each: $________ "Gospel Songs I Grew Up WIth" CD: Qty:_____ Total @ $15.00 each: $________ CLA Jacket Qty:_____ Total @ $160.00 each: $________ Size: Sm ___ Med ___ Lg ___ X-Lg ___ XX-Lg ___

"Baruch Hashem" - Not a Discounted Item CD Qty:_____ Total @ $4.00 each: $________
Total Order: $________ Payment Method: Check ___ Money Order ___	Mail To: Country Legends Association P.O. Box 7171 Duluth, MN 55807-7171 Telephone: (218) 626-9044