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Mail-In Form For Friday Jazz Service



City:       State:    Zip code:  

No. of copies of Friday Night Jazz Service:    @ $17.50 per CD

Amount Enclosed:   $(xx.yy)

Please print this form, enclose with your check, and mail to:

      Robert Applebaum
      1120 Windsor Way
      Menlo Park, CA 94025
(Note: This is my new mailing address)

If you send a check please make sure you do two things:
      1.   Include your mailing address with your payment. (Fill-in then print this handy form).
      2.   Send me an e-mail at to let me know you are sending a check.
      (If I am going to be away from home I will let you know that there will be a delay in my shipping
      the CD out to you.)

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