Center4CreativeArts

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Center for Creative Arts - "Twas the Night Before Christmas" - December 18, 2004 Performance Order Form

Please provide the following information so, that we may process your order accurately:

QTY	DESCRIPTION
	DVD Copy/ies of December 18, 2004 performance. $ 32.00/copy

	VHS Copy/ies of December 18, 2004 performance. $ 27.00/copy

	BILLING INFORMATION
Credit Card
Card Number Cardholder Name	Expiration Date
Street Address
City
State/Province	Postal Code
Phone
Email Address
Delivery Instructions (Select One)

If you want your video shipped directly to you, please fill in the following information.

(Note: there will be an additional shipping charge added to each order to cover the cost of shipping.)

SHIP TO the following address:

First Name Last Name

Street Address

Address (cont.)

City

State/Province Postal Code

Phone Number