the Eligibles CD order form

Please note: Although it is most unlikely that you will experience any problems responding to this form, certain non-standard browsers will not respond properly. If you experience any difficulties, (or if you are not using a forms-capable browser) you may email your response to this form to: eligibles@findusat.com.

Please select cassettes and amount ordering.

Name:

Address:

City:

State:

Zip code:

Country:

tentatively available at $11.95

Quantity ordered:

Please be sure to include all information necessary to fill your order. Name, address, city, state, zip code, credit card number, and expiration date are important.

Please enter quantity of each cassette(s) ordered in the comment box.

Credit card number:

AMEX
MC
VISA

Jan
Feb
March
April
May
June
July
August
Sept
Oct
Nov
Dec

1997
1998
1999
2000
over 2000

Please add $1.00 for shipping to each order