Centennial DVD Order Form
* Make checks payable to: DPCA
Name: __________________________________________________
Address: ________________________________________________
City: ____________________________________________________
State: ___________________ Zip: _________________________
Email: ____________________________________________________
Number of DVD: _________ x $19.95 each. Total DVDs $_________
Shipping outside of the US is $5.00 extra.
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Payment must be made in US Funds and drawn on a US bank. There will be a $25.00 service charge for any check not honored by the bank.
Print, complete, and mail this form along with your check/money order made payable to DPCA to:
Michelle Kramer
3345 Musgrove Rd.
Williamsburg, OH 45176-9728