2007 Miss Michigan Video Order Form

Please Print Name_______________________________________________________________ Address_____________________________________________________________ ____________________________________State__________ Zip_______________ Phone  (______)_______________________ Pageant Videos Desired: _______@ $89 + $4 s/h + $5.34 tax..............................................................$98.34 ea. Interview Videos Desired:   _______@ $20 (If ordered with the Pageant video) + $1.20 tax....................$21.20 ea. _______@ $30 (Interview video only) + $4 s/h + $1.80 tax..........................$35.80 ea. > Name of contestant desired in interview video_______________________________                          NOTE: Videos will be available in DVD format only                                                                               ORDER TOTAL $______________                         Please make checks payable to Beam Sound & Video Charge Card Purchase (Master Card, Visa or Discover): Card Number _________________________________________ Expiration Date ___________________ Name on Card ________________________________________ Your Signature ________________________________________

Print out and mail to: Beam Sound & Video 1125 W. Michigan Ave. Three Rivers, MI  49093

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