Order Form
Please print out this form, fill in all information and send it with your check or money order to:

. Make check payable to Diva Destruction.

Customer Information:	Ship To:
Name:	Name:
Address:	Address:
City:	City:
State/Province:	State/Province:
Zip/Postal Code:	Zip/Postal Code:
Country:	Country:
E-mail:

Description	Qty	Unit Price	Total
Passion's Price CD		$15.00
Diva Destruction T-Shirt , Size:		$17.00
Diva Destruction Sticker		$  1.00
Diva Destruction Poster		$  6.00 (add $ 1.00 for tube)
NOTES:		Item Total
		Sales Tax (CA residents add 8%)
		Shipping Fee U.S.	0.00
		Canada	2.00
		International	4.00
		Grand Total