Alzheimer's Videotape Mail Order Form

Please print this order form, make your selections and mail it to:

Lake Solitude Media, LLC
P.O. Box 463
Casper, WY 82602

$2.00 discount per additional video when ordering more than 1 video

Tape
Price
Check
for
Selection
Format

(Circle one)

Be Still My Soul
16.95
_______
DVD
Joyous Wings
16.95
_______
DVD
Majestic Collection
16.95
_______
DVD
Nature's Melody
16.95
_______
DVD
Reflections of Praise
16.95
_______
DVD
Nature's Splendor
16.95
_______
DVD
Softly and Tenderly
16.95
_______
DVD
Wilderness Treasures
16.95
_______ DVD
Colors of Fall
16.95
_______ DVD__VHS
Magnificent Birds
16.95
_______ DVD__VHS
Beautiful Wyoming
16.95
_______ DVD__VHS
The Flowering Desert
16.95
_______ DVD__VHS
Beyond the River of Grass
16.95
_______ DVD__VHS
Life Beneath the Sea
16.95
_______ DVD__VHS
Appalachian Spring
16.95
_______ DVD__VHS
SUB TOTAL
_______
DISCOUNT
$2.00 discount per additional video when ordering more than one video
_______
SHIPPING

$4.95 for one video- add $1.00 for each additional video

_______

TOTAL _______
Please make checks or money orders payable to:
Lake Solitude Media, LLC
Allow seven days for shipment after receipt of personal checks
Ship to:
Name: _________________________________________________
Mailing Address: ________________________________________
City: _______________________ State: ____ Zip: _____________
Phone: ________________________________________________
MONEY BACK GUARANTEE
If you are not satisfied with Lake Solitude Media's videotapes please feel free to return them for a complete refund.
Telephone: 1 (307) 473-2566
© 2007 Lake Solitude Media