LandiaMusic, Inc.
Mail Order Request
Please print out and mail

Your Name:	________________________________________
Address:	________________________________________
Zipcode:	________________________________________
Phone:	__________	Email:	_______________________

"Unleashing the Truth" CD	_______	X $12.00 ea =	________
"Unleashing the Truth" T-Shirt	Specify size: M-L-XL-XXL
Light gray 100% cotton	_______	X $15.00 ea =	________
Landia Band Signed Picture (Limited Edition)	________	X $5.00 ea =	________
LandiaMusic sticker (If stickers ordered separately, minimum order is 3)	________	X $1.50 ea =	________
		Sub:	________
California residents add 8.25% Sales Tax		Tax:	________
		Shipping:	________
		Total Order:	________

If using a credit card:
Visa Mastercard American Express

Card #:______________________________

Expiration Date:________________________

Signature_____________________________

Please allow 2 to 4 weeks for processing. California Residents add 8.25% Sales Tax.
Mail order form with a check or money order to:

LandiaMusic, Inc.
P.O. Box 36677
Los Angeles, CA 90036-0677
USA
e-mail:info@landiamusic.com