KGM Videos      Order Form

Specify DVD or VHS in Description

Quantity

Print # and Description of Video

Price

Total

$19.95

$_______ .00

19.95

$_______ .00

19.95

$_______ .00

19.95

$_______ .00

19.95

$_______ .00

19.95

$_______ .00

All Videos and DVD's $19.95/ Plus Shipping
Shipping Costs are $3.00 for the first video or DVD.
add $.50 shipping for each additional video or DVD.
Mass. Residents add 5% Sales Tax

+ Shipping

$ ______.___

Total

$ ______.___

Print this form and Include with your order.
Fill Out Entirely to Insure Proper Delivery
To Speed up Delivery...
Send Postal Money Order
or Send Check To:

KGM Video
77 Peros Drive
Agawam, Mass.
01001

Thank You, KGM Video

www.vintagemodifieds.com 

Shipping Information:

Name: .......................................................

Address: ...................................................

City: .........................................................

State/Province: .......................................

Country: ..................................................

ZIP Code: ............................................

EMail Address: .......................................