| Name ___________________________________ | Phone_____________ | |
| Address____________________________________________________ | ||
| City ________________________ | State _______ | Zip Code__________ |
|
Qty |
Item |
Price |
Ext Total |
| CD "The Man I Am" 2011 |
15.00 |
||
| CD "The Other Half, 2007 |
12.00 |
||
| CD "One For Me", 2003 |
10.00 |
||
| **T-Shirt, Chris Himel & Outbound |
15.00 |
||
| **Specify Size** | size | ||
|
|
SUB-TOTAL |
||
|
Add 2.50 per item |
SHIPPING |
||
|
|
TOTAL |
Send check or money order, for the total amount to:
|
Chris Himel |
|
147 Gena Marie Dr |
|
Lafayette, LA 70506 |