Great Places in South Jersey
Mail Order Form
Directions: Please print this page.
send me __________
DVD
or _____________ VHS
tape (same price)
Complete this form and mail with a check or money order made payable to Clay
Mikolasy for $14.99 + $5 for
shipping & handling using UPS Ground or USPS Priority Mail in the US = $14.99 total for 1 video
(New Jersey residents please add $1.05 for 7% NJ Sales tax). International orders, please email
to make arrangements before ordering.
$_________________ Total amount enclosed
Please print neatly!
Your Name ________________________________________________
Your Mailing Address
_________________________________________________________
_________________________________________________________
Daytime phone (optional) _____________________________________
Mail this form with your check or money order to:
Clay Mikolasy
712 Glenside Rd
Millville NJ 08332
© 2008 Clay Mikolasy, Producer of "Great Places in South Jersey" for further info, email