To order your Convention 2000 video, please print this form, complete the information, and mail along with your check or money order to the address listed at the bottom of the page.  Please Print All Information!

 

Congressional Medal of Honor Convention 2000
Pueblo, Colorado

Video Order Form

Name: _______________________________________________________

Address: _____________________________________________________

Street Address if different from above: _______________________________

City: __________________________  State:_________  Zip: ____________

How many tapes do you wish to order?   __________
Enclosed please find:  $___________ for ______ Convention 2000 video tapes.

If you are ordering more than one video tape and wish to have copies mailed to other persons, please provide names and shipping addresses below. 

Name:  _________________________________________________
Shipping Address:  _________________________________________
City:  ___________________________ State: _____  Zip: __________

Name:  _________________________________________________
Shipping Address:  _________________________________________
City:  ___________________________ State: _____  Zip: __________

Name:  _________________________________________________
Shipping Address:  _________________________________________
City:  ___________________________ State: _____  Zip: __________

Mail this form with the appropriate payment to:

MOH Convention Committee
%Paulette Stuart
P.O. Box 4040
Pueblo, CO  81003

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