Kanawha Pipes and Drums CD order form

Kanawha Pipes and Drums
~Check Payment Order Form~ ---------------------------------------------------------------------------------------------
MAIL TO:

Name:____________________________________________

Address:__________________________________________

City:______________________ State:_____ Zip:__________

Phone:(_____)____________________

Email address:______________________________________

Qty Item Description Price Total

Kanawha Valley Pipes and Drums CD x $15.00

Kanawha Valley Pipes and Drums T-shirt x $10.00

(indicate sizes desired)

TOTAL

Please send check or money order payable to:
Steve Hendricks
107 Hidden Acres
Scott Depot, WV 25560

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Qty	Item Description	Price
	Kanawha Valley Pipes and Drums CD	x $15.00
	Kanawha Valley Pipes and Drums T-shirt	x $10.00
	(indicate sizes desired)
		TOTAL
Please send check or money order payable to: Steve Hendricks 107 Hidden Acres Scott Depot, WV 25560