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ORDER FORM

Print out, fill in and check the necessary blank spaces below.

Name__________________________________________________________________________

Organization____________________________________________________________________

Address________________________________________________________________________

Phone/Fax______________________________________________________________________

Email__________________________________________________________________________

* Number of individual copies:  ____  X  $20  =  _____ (Your cost)

* Preferred format/s:  VHS_____          DVD_____

 

How did you hear about the documentary?

 

Feel free to fax the completed order form ahead of your payment.  Please make your check payable to At The ROOTS Films.  Once your order is processed, please allow 3 to 10 days for shipping.  Send payment to:

 

 4647 N. Magnolia Ave., Unit G

 Chicago, Illinois 60640

 Phone: (773) 957-5455   Fax: (773) 334-7589

 attherootsfilms@yahoo.com

 www.attherootsfilms.com

 

Thank you for your purchase.

 

 

 

 

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