KEITHURBANFANS.COM MAIL-IN ORDER FORM

Please print off the following order form and fill it out accordingly. Mail this with your enclosed payment.

USA CUSTOMERS
We accept cashiers checks or money orders. We can not accept personal checks. Cash at your own risk.

INTERNATIONAL CUSTOMER (outside of USA)
We can only accept US cash at your own risk. We can not accept international money orders, cashiers checks or personal checks.
The best payment option for international customers is to use our online ordering method.

MAKE PAYMENTS PAYABLE TO
ST.JUDE / ALSAC. We can not accept payments made out to KeithUrbanFans.com.

MAIL PAYMENT & ORDER FORM TO
KEITHURBANFANS.COM / P.O. Box 676 / Lakemore, OH 44250

SHIPPING COSTS
USA Customers: $3.95 and then $2.00 per additional calendar
CANADA Customers: $5.95 and then $2.00 per additional calendar
OTHER Customers: $9.95 and then $4.00 per additional calendar

----------------------------------------------------- PRINT ALL OF BELOW -------------------------------------------------------------

Name:
________________________________________________________________________________
   
Address:
________________________________________________________________________________
   
City/State/Zip:
________________________________________________________________________________
   
E-Mail Address:
________________________________________________________________________________

 

Item Information

Item
Price
Quantity
Shipping
Amount

2017 Keith Urban Calendar

$15.00
__________
$ ___________
$ ___________

2016 Keith Urban Calendar

$7.99
__________
$ ___________
$ ___________

2015 Keith Urban Calendar

$4.99
__________
$ ___________
$ ___________

2014 Keith Urban Calendar

$4.99
__________
$ ___________
$ ___________
2012 Keith Urban Calendar
$4.99
__________
$ ___________
$ ___________

2010 Keith Urban Calendar

$4.99
__________
$ ___________
$ ___________
2009 Keith Urban Calendar
$4.99
__________
$ ___________
$ ___________
Total:
$ ___________