ORDER FORM

NEW VISTA MUSIC
Jack Downey
2005 Coon Hill Road
Skaneateles, New York 13152

Send Order To:

Name: ___________________________________________________
Address: _________________________________________________
City / State / Zip Code ______________________________________
Contact Info (Phone and e-mail) ______________________________

____ $25.00 : The Stained Glass Collection (Entire Collection)

____ $ 5.00 : Loose Leaf - Single Selection of any work.

____ $10.00 : CD of the above selections

__X_ $ 5.00 : Shipping and Handling


Total Order is : $________________

Please make checks payable to: Jack Downey