CD Order Form

Jackie's CD Order Form

$15/CD plus $1.50 S&H/CD ($2.50 International)

Please submit the following order information. Make check payable to:

(Orders will ship as soon as payment is received)

Jackie Bankston

2057 Magnolia Pisgah Rd.

Summit, MS 39666

First Name Last Name

Street Address

City

State/Province Zip/Postal Code Country

Home Phone

E-mail

Qty of Just Jackie CD's Qty of It's Me Again CD's

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	Qty of Just Jackie* CD's* Qty of It's Me Again* CD's*