Order Form

Please print and mail a copy of this completed form along with your check or money order to:

Leilani Clark
4132 154th Terrace
Wellborn, Florida 32094

Please make check or money order payable to:  LEILANI CLARK

FORMAT PRICE/EA*. AMOUNT
Never Say Goodbye $15.00/each x____ _______
"I'm Amazed"- CD $10.00/each x_____                
"I'm Amazed"- Cassette   $8.00/each x______                
Keeper of My Heart- CD Single $3.00/each x _____ ________ 
I Had No Idea
(artist: Val Halloran)		 $15.00/each x____ _______
  Shipping/Handling $2.00
  TOTAL                

Thank You for Your Order! May you be blessed by each song in the album(s) you purchased.

SHIP TO INFORMATION:

Name 

                                                                   

Address

                                                                    

City/State/Zip

                                                                   

Your phone number
(or email address)

                                                                    

 

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To Contact Us:

Phone: (386) 963-4941
Email: The Clark Family

 Wellborn, FL

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