ANDREA LELAND HOME VIDEO ORDER FORM

Use this form when ordering videos for personal, in-home use only.

This form is not for orders by institutions, community groups, libraries or schools.

Please provide the following information:

Name:

Address:

City:

State:

Postal Code/ZIP:

Country:

Phone:

Email:

Items in bold are required to process your order.

Title
Quantity
Price each
=
Subtotal
Jamesie, King of Scratch
(available in DVD format only)
 
$45
=
 
The Garifuna Journey  
$35
=
 
The Long Road Home  
$35
=
 
Voodoo and The Church In Haiti
(available in DVD or VHS video format)
 
$35
=
 
*Shipping is $12.00 for the first video, and $3.00 for each additional video. >> Subtotal    
=
 
*Shipping   
=
 
Total   
=
 

Mail this form, along with your check, to:

     Andrea E. Leland
     530 Forest Avenue
     Evanston, Illinois 60202
     USA

Checks must be in US$ payable to " Andrea E. Leland"