David Frizzell Merchandise

Merchandise Order Form

Please print this order form from your browser, fill it out completely and mail with payment. Please make sure all entries are legible and correct.

Date _________________________________

Name ______________________________________________________________

Address ____________________________________________________________

City ____________________________________ State ____________ ZIP Code _________

Telephone: (_______)___________________ FAX: (______)________________________

E-Mail:_______________________________________________________________________________

Fan Club Member ID Number: ______________________ Special Offer Code: ____________________

Enclosed: □ Personal Check □ Money Order □ Cashier's Check

QTY	DESCRIPTION	PRICE EACH	AMOUNT







NOTE: All prices are in U.S. Dollars. * US Priority Mail Shipping & Handling: $6.00 International Global Priority Mail Shipping & Handling: All countries - $15.00 * NOTE: If joining the Fan Club only or in addition with merchandise purchases, please add $3.00 shipping. Make payable and mail to: Lakota, Inc. 1300 Division #301 • Nashville, TN 37203		Sub Total	$
		* US Priority Mail Shipping & Handling	$
		*** International Global Priority Shipping & Handling	$
		*** Fan Club Shipping	$
		TOTAL	$