LesterQ.com International order form

please print form and complete by hand or create a reasonable faxsimile

CD	PRICE	SHIPPING	QUANTITY	FORMAT
Oh My!	15 Euro / $17 US	3 Euro / $4 US	[____]	CD
So Here We Are	15 Euro / $15 US	3 Euro / $4 US	[____]	CD
Tri-Continental Live (2 CD)	28 Euro / $28 US	3 Euro / $4 US	[____]	CD
A Big Love	12 Euro / $15 US	3 Euro / $4 US	[____]	CD
Keep On Walking	12 Euro / $15 US	3 Euro / $4 US	[____]	CD

Payment must be made by money order or cheque.

Please make cheques payable to Poetical License Inc. and send to:

Poetical License Inc.
Box 135
Pender Island, B.C.
V0N 2M0, Canada

Name:
__________________________________________________

Address:
__________________________________________________
__________________________________________________
__________________________________________________

Email address:
__________________________________________________