Friday Night BLITZ Order Form

Today's Date
Name
Address
City
State
Zipcode
Phone
Fax
Email
Blitz Broadcast Information
Date of Broadcast
Media Type	Choose Type VHS DVD
Number of Copies
Mastercard or Visa	No dashes
Expiration Date	YYYYMMDD
OR: Mail check immediately to: CDS, 167A Haywood Rd., Asheville NC 28806