"From Up Over To Down Under: And Back" CD-R
USA Order Form

visits since 13 August 2006

For Customers in the USA
please send $25:00 ($US) to:-

Jack Heyn
505 - 36th Street, Unit 303,
Des Moines,
IOWA 50312, USA

 jheyn.jpg (10544 bytes)

Jack Heyn

Please print out a copy of this page and print your name
and address clearly below and include with your payment

MY NAME: ....................................................................................... 
MY ADDRESS:................................................................................

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Please print clearly