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Gala DVD Order Form

A limited number of DVDs will be produced, based on the orders we receive. Thank you!

	Name*

	Address*

	City*

	State*

	ZIP Code*

	Country*

	Daytime Phone*

	Evening Phone*

	Email*

	DVDs are $25 each. Please indicate how many you wish to order.*

	In this box, please indicate how much should be charged to your credit card (this will not change automatically if you change the number of DVDs in the item above):*

Please Note: Questions marked with an asterisk (*) are required.

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