order form

       REMINISCE                                           ACOUSTIC PATHWAYS                                  

            PRINT, FILL OUT, & MAIL THIS FORM AND PAYMENT TO:
                                               

                                      Wayne Kinton   
                                       P.O. Box 1324
                                       Henderson, N.C.  27536

            Make Checks and Money Orders Payable To: Wayne Kinton

_________________________________________________________
NAME
_________________________________________________________
ADDRESS
_________________________________________________________
CITY / STATE / ZIP CODE
_________________________________________________________
PHONE NUMBER
_________________________________________________________
DATE OF ORDER
_________________________________________________________
CUSTOMER'S SIGNATURE

_________________________________________________________
CUSTOMER'S EMAIL ADDRESS


Quantity
________ REMINISCE..... $15 per CD

________ ACOUSTIC PATHWAYS..... $15 per CD (shipped in December)

Includes Shipping in Continental USA

$ _________ TOTAL PURCHASE

                Thank You