Clem CD Order Form

Please provide the following ordering information:

QTY	DESCRIPTION
	Aplifying The Obvious - Live from Four Stools CD

	SHIPPING
Name
Street Address
City
State/Province
Zip/Postal Code

Please Send Check or Money Order to:

Clem CD
1601 Reserve St.
Stevens Point, WI 54481

Please make check or money order payable to AJ Koch
Allow 10-14 Days for delivery upon receipt of payment