TO ORDER BY CHECK OR MONEY ORDER WITHIN
THE USA ONLY
FOR ORDERS OUTSIDE
THE USA: If
you prefer not to pay using a credit card please
inquire by email or telephone: 510-841-4128
1. Print
out this form
2. Fill it out
3. Make check or money order to: Harrod Blank
4. Mail to: Camera Van, 2248 Summer St., Berkeley CA 94709-1438
Price/Qty. Title
______/_____WILD
WHEELS BOOK
$18.95 Plus Shipping and Handling
______/_____WILD
WHEELS VIDEO - VHS FORMAT
$20.00 Plus Shipping and Handling
______/_____WILD
WHEELS VIDEO - PAL FORMAT
$30.00 Plus Shipping and Handling
______/_____DRIVING
THE DREAM VIDEO - VHS FORMAT
$20.00 Plus Shipping and Handling
______/_____DRIVING
THE DREAM - PAL FORMAT
$30.00 Plus Shipping and Handling
______/_____IN
THE LAND OF THE OWL TURDS VIDEO - VHS FORMAT
$20.00 Plus Shipping and Handling
____________SUBTOTAL
____________TAX California residents only please add 7.25% CA sales tax.
$5.00 ADD $5.00 FOR SHIPPING AND HANDLING WITHIN THE USA
$___________TOTAL
PURCHASER INFORMATION:
All of your personal information is strictly confidential
and will not be sold nor shared with anyone for any reason.
Name:_______________________________________________________
Address:_____________________________________________________
____________________________________________________________
City: ________________________ State:____________ Zip:____________
Email:________________________________________________________
Phone
Number (optional):_________________________________________
MAILING ADDRESS IF DIFFERENT FROM ABOVE:
Name:_______________________________________________________
Address:_____________________________________________________
City: ________________________ State:____________ Zip:____________