To order, print a copy of this form, complete, and mail the address below. Address: Name:_____________________________________________________________ Address:___________________________________________________________ City:_________________________________ State: _______Zip:_____________ Daytime Phone Number: (________) ________-__________ Email address where we may contact you with any questions: __________________________________________________________
Item:	Personalized Name	Price	Qty	Total
CD Photos Tool Time #1 Tool Time #2 Tool Time Truck Golf #1 Golf #2 Mickey #1 Mickey #2 Mickey #3 Mickey #4 Mickey #5 V#1 Mickey #6 V#2 Mickey #8 "V" Convention Video	____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________	__$15.00__ __$10.00__ __$10.00__ __$10.00__ ___$5.00__ __$10.00__ ___$5.00__ ___$5.00__ ___$5.00__ ___$5.00__ __$10.00__ __$10.00__ ___$5.00__ ___$20.00__	_________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________	______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________
Postage and handling:			Postage:	**$5.00**
			Total:	_______________
Special personalization info:
Method of payment: ________ Check or ________ money order for $__________ enclosed.(USA funds only) Mail To: Send order form along with your check made out to: Mickey Jones c/o Shoestring Productions P.O. Box 940321 Simi Valley, CA 93094-0321 **Please allow 4-6 weeks for delivery.**
Mailing Label (print legibly,please) Name:_______________________________________________________________ Address:_____________________________________________________________ City:______________________________State: ___________Zip:______________