Barrymores Online Store Mailorder Form 
               (Credit Card online billing coming soon)
***************************************************************
Directions:

Print form, fill out, and mail (with well-conceiled check, money order, or cash) to

The Barrymores
94 Macalester Bay
Winnipeg, MB, CA
R3T2X5

***************************************************************

Name:_______________________________________

Address:____________________________________

Province/State:_____________________________

Country:____________________________________

Products (codes on website, or just write down description):

#1:_____________________________

#2:_____________________________

#3:_____________________________

#4:_____________________________

#5:_____________________________

     If more space needed, just add lines on right hand side as needed.

Amount Enclosed:$_____________________________  US / CDN (circle one)


Thank you!
*********************************************************************

www.thebarrymores.com                         band@thebarrymores.com