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Distant Thunder Films Order Form



Last Name:__________________________________________ First Name:______________________________________


Phone Number:_______________________________ E-mail:___________________________________________


Address:________________________________________________________________________________


City:_______________________________________________ State:________ Zip Code:________________


ITEM #_____________ QUANT.______ COLOR_______________ SIZE_____________________


ITEM #_____________ QUANT.______ COLOR_______________ SIZE_____________________


ITEM #_____________ QUANT.______ COLOR_______________ SIZE_____________________


ITEM #_____________ QUANT.______ COLOR_______________ SIZE_____________________


ITEM #_____________ QUANT.______ COLOR_______________ SIZE_____________________


ITEM #_____________ QUANT.______ COLOR_______________ SIZE_____________________




--------------Sub Total $_________________________

Shipping & Handling= $___________________________

---------------TOTAL: $___________________________



COMMENTS:___________________________________________________________________________________

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