Glamore Productions

10115 W. Grand Ave.
Franklin Park,Il 60131
(847) 455-5369

Star Performers Video Store Order Form

Make your selections by show number

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Shipping and Handling $4.00
Total Enclosed $

SHIP TO: NAME _______________________________________ DAY PHONE (_____)______________

ADDRESS:________________________________________________________ APT:_______________

CITY:____________________________ STATE: _________________________ ZIP:_________________