THE HIGHWAY BEAUTIFUL mail order form

• Print it out,
• Fill it out,
• Mail it in . . .

Quantity	Product Description	Size	Price	S & H	Total
		"Upside"- Black 50/50 T whte/pink ink (YL) (S) (L)	$20.00	$ 3.00	$
		"Upside"- White 50/50 T black/ blue ink (YL) (M) (L)	$20.00	$3.00	$
		"Swirl" Black 50/50 T w/ white/blue ink (YL) (L)	$20.00	$ 3.00	$
	"The Things That Lights Can Hide"	Full Length CD	$12.00	$ 2.00	$
		TOTAL

Ship to:

Name: _________________________________________________________

Address: ________________________________State:_____ Zip: _________

Make check payable to:

The Highway Beautiful

Send this Form and Check to:

The Highway Beautiful

attn: Jason Jurewicz

5710 Homestead Rd

Hamburg, NY 14075