ORDER FORM

Please Print out this form and fill out the information.

Name: _____________________________________________

Address: ___________________________________________

Apt # or Suite: ______________________________________

City, State & Zip: ____________________________________

Telephone: _________________________________________

Email Address:_______________________________________

Tape Prices:
"Death of a Corner Drugstore"                                      $ 25 individual rate

                                                                                $100 institution rate

"8 mm. Dreams"                                                          $15 

"2001 Wearable Sculpture Fashion Show"                       $ 30  

"Waiting For Houdini"                                                  $ 20 individual

                                                                                $ 75 insitution

Please include $4 shipping for each tape ordered.

Tape Title            # Ordered      Cost      Shipping        Subtotal   

Total Enclosed:

Please allow 4-5 weeks for delivery.

Send Payment and Order form to:
Magpie Media Inc., PO Box 11134, Milwaukee, WI 53211  USA

To order "Midwestern Gothic" go to: www.joyfarm.com

Contact Information

Telephone                                Fax                                    email

414-964-6018                    414-271-9669                      brooke@magpiemedia.com

Magpie Media, Inc., PO Box 11134., Shorewood, WI  53211  USA