| Quantity | Item Description | Unit Price | Total |
| ______ | "Mojo Gurus" T-shirt LARGE | $12.00 | _________ |
| ______ | "Mojo Gurus" T-shirt X-LARGE | $12.00 | _________ |
| ______ | "Mojo Gurus" CD | $15.00 | _________ |
| ______ | Video Compilation w/ "Time Bomb", "Hot for Love", "Scratch My Back", "No Easy Way Out" and "Tiger Lily" | $20.00 | _________ |
| ______ | Tour Poster | $5.00 | _________ |
| ______ | New Band Photo | $2.00 | _________ |
| ______ | "Drinkin' TNT and Smokin' Dynamite" CD | $10.00 | _________ |
| ______ | "Things You've Never Done Before" CD | $15.00 | _________ |
| ______ | "The Voodoo You Love" CD | $15.00 | _________ |
| ______ | "Love 'Em And Leave 'Em" CD | $15.00 | _________ |
| ______ | "Old, New, Borrowed and Blue" CD | $15.00 | _________ |
| ______ | Things You've Never... T-shirt LARGE | $12.00 | _________ |
| ______ | Things You've Never... T-shirt X-LARGE | $12.00 | _________ |
| ______ | The Voodoo You Love Tour T-shirt LARGE | $12.00 | _________ |
| ______ | The Voodoo You Love Tour T-shirt X-LARGE | $12.00 | _________ |
| ______ | Grunge Sucks T-shirt LARGE | $12.00 | _________ |
| ______ | Grunge Sucks T-shirt X-LARGE | $12.00 | _________ |
| ______ | High Five T-shirt LARGE | $12.00 | _________ |
| ______ | High Five T-shirt X-LARGE | $12.00 | _________ |
|
Shipping ($5.00 for U.S. and Canada, $10.00 for International) |
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GRAND TOTAL |
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| Name:_______________________________________________
Address:_____________________________________________ City:__________________________________________ State:_________________________________ ZIP:_______________________ Credit Card Type: Visa / MasterCard Credit Card Number:___________________________________ Expiration Date:_____________ If not paying by credit card, make your money order payable to The Mojo Guru and mail with this form to: ROXX GANG Allow 4 to 6 weeks for delivery. Longer for international orders. Click here to close this window. |
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