M&R RUSH

Printable Order Form
Please make your check or money order payable to and mail this form to:

M&R Rush
PO Box 556
Dyer, IN 46311

MUSIC

Item Description	Quantity	Price Each	Shipping & Handling	Extended Total
The NEW M&R Rush CD Album Keep on Rockin’		$12.97	$2.00
The Thrill Of The Chase CD Album - 2004		$12.97	$2.00
Rock & Roll Chicago CD Album 2003		$12.97	$2.00
M&R Rush CD Single - 2006 You Don’t Want to Mess With a Hungry Bear		$3.00	$2.00
M&R Rush CD Single -2004 I’m Dreamin’		$3.00	$2.00

Mechandise

M&R Rush Baseball Hat (circle color: Tan - White - Denim)

$12.97

$2.00

Keep on Rockin’ Tour T-shirt (circle color: Blue - Brown - White) (circle size: S - M - L - XL)	$12.97	$2.00
Ladies M&R Rush T-shirt (circle color: Black - Apricot) (circle size: S - M - L - XL)	$12.97	$2.00

GRAND TOTAL:

SHIP TO ADDRESS:
Name ___________________________________________
           (First, Last, M.I.)
           ___________________________________________
( Street or P.O. Box )
           ___________________________________________
           ( City, State, Zip )
            ___________________________________________
           ( Daytime Telephone Number )
            ___________________________________________
           ( E-Mail Address )

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We will attempt to have your order delivered to you within 4 weeks. We will only call or e-mail you if we have a question or if there is a problem with your order.
Thanks!