Order Form

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Name:  _______________________________________

Street Address:  _______________________________

City:   ________________________________________

Province/State:   _______  Postal Code:   __________

Country:   _____________________________________

Phone Number:   _______________________________

E-mail Address:   _______________________________


Item  Price/Unit  Quantity Cost
 Latkes  $12 each
**
 The Roses on Annie's Table  $20 each
($15 for each
additional copy)
   
 The Indispensible Stringband  $35    
 Gabriola
V0R 1X0
 
$20    
 Old Folksinger's Pick (2 CDs)  $20    
 Sulphur Passage Video  $10    
 Settling Clayquot  $20    
Fancy Postage:  
Total Amount:  

** In Canada: $12 , including mailing; $10 
for additional copies to the same address.

**   In the US: $15 , including mailing; $12
for additional copies to the same address.



Any additional comments?

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________

Please make your cheque payable to Bob Bossin and mail with this form to:

Bob Bossin,
2455 Islandsview Drive,
Gabriola Island, BC,
Canada
V0R 1X7.
Thank you!



   *Are there other people we should contact? Please let us know.

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