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Please fill out the form clearly, specifying the videos you would like to order, and mail the form with payment to the address as the bottom.


Yes, I would like to order the following programs:

1 2 3 4 5 6 7 8 9 10 11 12 (Circle the numbers)


Name ___________________________________________________


Address__________________________________________________


City / State ____________________________  Zip: ___________  Phone: (____ ) ____________


Total Amount Due: ____________________  Payment Enclosed: ___________________



Date:____________________


***Deduct $5.00 for any three tapes -- call for other discounts***

Pay by check or money order – no credit cards.
Price – $19.95 each (plus $2.00 postage and handling) for destinations within the United States.
Make the check or money order out to "Lewis and Clark Chapter"
No credit cards, please.

Mail to:
LC Chapter - OSSAR
PO Box 1594
Lake Oswego, OR 97035

Call toll-free 1-(800)-947-8697 for further information.

Please specify here if your prefer video CD's (DVD's) __________

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