Name: _______________________________________
Street Address: _______________________________________
City, State & Zip Code: ________________________________________
Telephone: (______) ________________________________
E-Mail: _________________________________________
Please check item(s) ordered:
CD-R....................Quantity ____ @ $20 each = $ ______
Booklet.................Quantity ____ @ $20 each = $ ______
Set(1 of each)........Quantity ____ @ $35 each = $ ______
Total Enclosed...................................................$ ______
Send a Check or Money Order made payable to "Frederick E. Burdick" to:
Frederick E. Burdick, 595 Taugwonk Road, Stonington, CT 06378
Please remember: Proceeds in excess of production and shipping costs (US Mail) will be contributed to The Avery Memorial Association. If you have any questions, please phone Fred at 860-535-8454 or e-mail him at fburdick@comcast.net