MAIL ORDER FORM

 
Please complete this form, print it, and send it in along with a check, money order, or purchase order to:

Grant Baldwin
1440 Eastland Ave
Springfield, MO 65802
SHIPPING INFORMATION

PRODUCT ORDER FORM
Item

Quantity

  Size/Color  

Price USD

Total
  Reality Check Book     $14.95
         
  "Live out Loud" T-Shirt   $19.95
          
  "Excuses" T-Shirt   $19.95
          
  "No More Excuses" Wristband   Varies. Info.
          
  Reality Check + "Live Out Loud" T-Shirt + Wristband Combo   $26.95
          
  Reality Check + "Excuses" T-Shirt + Wristband Combo   $26.95
          
   Subtotal      
         
  Shipping       FREE 
          
  GRAND TOTAL      


Please make payments payable to GRANT BALDWIN