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Willy Wonka and The Chocolate Factory at Parkside DVD Order Form
Willy Wonka and The Chocolate Factory at Parkside DVD Order Form
Please fill out the form below and deliver it to Daniel Pfingstgraef by August 26, 2014.
We may be unable to fill orders that are not received by this date. Thank you!
Your name: ___________________________________________________________
Your phone number: ____________________________________________________
Number of DVD's ($15.00/each): ________________
Total amount due: __________________
Signature: ___________________________________
For administrative use:
Amount due paid in full?
Order placed?
Order picked up/shipped?