Order Form

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Order Form Yes, Please send me a copy of "Adopt-A-Collie"
No. of videos______@$15.00 each Total $_______.____

I am a volunteer with an animal rescue organization (name of org._________________)
Please send me: Number of videos______@$10.00 each Total $_______.____

I would like to make an additional donation to Southland Collie Rescue for: $_____.___

Please make checks out to: Southland Collie Rescue and mail this order form to:
Southland Collie Rescue - c/o Linda Ekback
9654 Old Creek Rd.
Ventura, CA 93001

Ship video to:
Name (please print):____________________________________________
Address:_____________________________________________________
City:_________________________ State:___________ Zip:____________
Phone:______________________ E-mail:___________________________