Dan BernMerch Order Form

Please print out this order form, or just write out your selections. Make checks out to Dan Bern. Send all orders to Bernstein Merchandise , PMB 411, 1158 26th Street, Santa Monica, CA 90403

Books

______ World Cup at $20 each

______ Quitting Science at $10 each


Cds

  ______ Breathe at $15

______ Breathe Easy at $10

______ Breathe / Breath Easy Combo at $20

______ Anthems at $5

______ My Country II at $8

______ Fleeting Days at $15

______ New American Language at $15

______ Smartie Mine TEMP OUT

______ Swastika EP at $10

______ Fifty Eggs on tape at $10

 

Please include these shipping and handling costs with your order!

For all orders, please include $3.50 shipping.

Your Address

Name ________________________________________ Email________________________

Street _____________________________________________________

City/State/Zip ______________________________________________



Thanks for ordering stuff!