COUNTRY MUSIC & DANCE IN SCOTLAND & NI
ORDER FORM

PLEASE SEND ME THE CD
'POPPING PILLS' BY JOHN MILLER
FOR £11.00

Title (Mr/Mrs/Miss etc) Initials Surname

Address:................................................................................................................................
.............................................................................................................................................
.............................................................................................................................................
Post Code:.................................
Daytime Phone No:
E-Mail Address:
Please send form with your £11.00 payment to:

BRIGITTE STRACHAN
19 Cambusdoon Place Kilwinning
Ayrshire
KA13 6SW

Thank you for your order
Tel 01294 - 552094
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