DVD Mail Order Form

Order Form

Rotary Club of:
Name:
Address:
City:
State:
Zip:
Phone:


Number of DVD's	@ X $20 =
Number of DVD's	X $4.00 Handling Fee

	Total

Please print the form and mail the completed form
with check payable to "Rotary Club of Fullerton".

Address:

Rotary Club of Fullerton
Dept. - Paul Harris DVD
P.O.Box 5111
Fullerton CA 92838