Dance Upstairs 2008 RECITAL DVD Order Form

*These will be edited by Starmount High School*

Dancer Name _________________________________________

Parent Name __________________________________________

Phone _______________________________________________

Circle Desired DVD

Performance One       $18.00

Performance Two      $18.00

Performance One & Two   $32.00

$__________ Cost DVD Ordered

  Plus $5.00    Shipping & Handling

$__________ TOTAL COST

Check _____ Cash _____

Address to send DVD to:

Street Address _______________________________________

City ___________________ State ______ Zip _____________

Mail this form with payment to: Dance Upstairs 246 East Main Street, Elkin, NC  28621

Check or Money Order Payable to: Dance Upstairs (Due by June 15th)