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

Print out this order form and mail it to:


The Cooters

Post Office Box 443

Oxford, Mississippi 38655

United States of America

662.232.8900


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


All Prices are Postage Paid!

We accept money orders, checks, and credit cards.  Make everything payable to "The Cooters"

All orders are filled within two days of receit, except however, if you send a check.

It will have to clear the bank before sending order (may take one extra week).



___ The Cooters "The Moon Will Rise Again" compact disc


                                ____ North America..................$10.00

                                ____ South America or Europe........$11.00

                                ____ Asia or Austrailia.............$12.00




                                                                	sub-total: ________



___ The Cooters "Invasion of The Cooters" compact disc


                                ____ North America..................$10.00

                                ____ South America or Europe........$11.00

                                ____ Asia or Austrailia.............$12.00



                                                                	sub-total: ________



__ The Cooters T-shirts


	______ Black 100% cotton t-shirt with white "Cooters Dice" on front and "Cooters Royal Flush" on back


                    ______ Small  ______ Medium ______ Large _______ X-large or  ______ XX-Large


                                ____ North America..................$15.00

                                ____ South America or Europe........$17.00

                                ____ Asia or Austrailia.............$20.00


                                                                        sub-total: ________





								Total order: ______________


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


Shipping Address:


Your Name:  ___________________________________________


Address:  _____________________________________________


City:  ________________________________________________


State:  ________________   Country:  ______________________


Zip Code:  ____________    email:  ________________________




Telephone:  (      ) ______-_______ 


Payment enclosed: $_______________


money order______ check______ credit card______ 


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


Credit card users (check one):


Visa_____ Mastercard_____ Discover______


Name on card:_________________________________________________


Credit Card number:___________________________________________


Experation Date:______________________________________________




Credit Card billing address:


Name:  ___________________________________________


Address:  _____________________________________________


City:  ________________________________________________


State:  ________________   Country:  ______________________


Zip Code:  ____________


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

Thanks for ordering from TheCooters.com!