| *First Name: | ______________________________ |
| *Last Name: | ______________________________ |
| *Address 1: | ______________________________ |
| Address 2: | ______________________________ |
| *City: | ______________________________ |
| *State: | ______________________________ |
| *Postal Code: | ______________________________ |
| *Phone 1: | ______________________________ |
| Phone 2: | ______________________________ |
| *Email: | ______________________________ |
| * Required |
| Quantity | Price | Amount | |
| Salsa Styling for Ladies Volume I: Technique and Styling (VHS) | ____ | $20 | ______ |
| Salsa Styling for Ladies Volume II: Syncopations and Style Variations (VHS) | ____ | $20 | ______ |
| Subtotal | ______ | ||
| FL residents add 6.5% Sales Tax | ______ | ||
| Shipping and Handling in continental US ($5 first tape, add $3 each additional tape) | ______ | ||
| Total | ______ | ||
Send check or money order payable to "Juliet McMains" to:
Juliet McMainswww.salsa-addiction.com
407-894-9090