Country Store Order Form

Order Form

QTY ITEM # DESCRIPTION SIZE / STYLE PRICE TOTAL

Send to:

Joe McDonald
P.O. Box 7064
Berkeley, CA 94707, USA
Subtotal _______
Add $5 for shipping & handling ($10 for posters) _______
TOTAL _______

Please print your name and address clearly so that Country Joe can read it! US addresses only.

Ship to: Name ________________________________________________

Street Address ________________________________________________

________________________________________________

City ________________________________________________

State ________________________

Zip code ________________________

Please inscribe item(s) to: ________________________________________________

________________________________________________

Make check or money order payable to Joe McDonald. (We regret that we can only accept US cash and US checks due to the exorbitant fees US banks charge for handling other types. We apologize to our international customers.)