ONLINE ORDER FORM

Get Shalane's CD - Lay the Heartache Down
by Mail

1. Fill in the form below making sure to include all information
2. Print out completed form on your home printer.
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3. Mail completed form and full payment to:
Shalane Christiansen
P. O. Box 924
Latexo, Texas 75849
4. Your order will ship within 2 weeks *
(Make Check or Money Order payable to Larry Bottoms.)

Ordering Information:
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Shipping Address if different from above:
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Number of CD's Ordered x $15.00 per CD = + $4.60 Shipping = Total Amount Due




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* Any order not paid in full will not be processed and returned to the sender.