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To order "The Silver Cord", please print this form and complete all information. Mail the completed form, along with a check or money order to the address listed below.
TO ORDER: Please send payment by check or money order. Each CD costs $12.00, plus shipping.
-Please add $2.50 U.S. Funds for THE FIRST CD and $1.00 for each additional CD for postage.
-If ordering from outside of the US, please include $4.50 for the first CD and $2.00 for each additional CD
-Make your money orders or checks payable to Dennis Tice.

MAIL THIS FORM AND YOUR CHECK OR MONEY ORDER TO:
Joshua Quest
Dennis Tice
503 South Juliana Street
Bedford, PA 15522

YOUR NAME ___________________________________________

ADDRESS _____________________________________________

CITY ________________ STATE ______ ZIP CODE ___________

PLEASE CIRCLE ONE OPTION BELOW:

I am ordering
1 CD: Total cost is $14.50, ($12 for the CD, plus $2.50 US shipping).

I am ordering
2 CDs: Total cost is $27.50, ($24 for 2 CDs, plus $3.50 US shipping).

I am ordering
3 CDs: Total cost is $40.50, ($36 for 3 CDs, plus $4.50 US shipping).

For more than 3 CD's, please e-mail us to tell us how many you would like to order at dtice@bedford.net