Memories of the 1998 National Unicycle Convention Order Form

Print this form and send it in with your payment. Make checks payable to Clifton Middle School.

Name: ______________________________________________________
Shipping Address: ______________________________________________________
  ______________________________________________________
  ______________________________________________________
Phone: ______________________________________________________
Format: NTSC (VHS in US) ____ PAL (Europe) _____
Quantity:
Tapes ordered: _____ × $20 _____
Shipping:  
$4 for first tape: $4
$1 for each additional tape (US, Canada, Mexico) _____
$2 for each additional tape (Elsewhere) _____
Total: _____

Send your cash or check along with this order form to:

Thomas A. Reale
71 E. Bonita Avenue
Sierra Madre, CA 91024
626-355-5976
iteach@earthlink.net

Allow 6-8 weeks for delivery