2010 Memorial Day Tribute to Concordia's Veterans

                                             DVD Order Form

Name ______________________________________________________________

Address ____________________________________________________________

City ___________________________    State _________    Zip ________________

# of DVDs  __________ @ $10.00 each            Total Enclosed $ _______________

Make your check payable to "Concordia Cemetery Association"  and mail your

order to:

                             Ray Johnson

                             7333 70th Street North

                             Glyndon  MN  56547

If you would like one or more of the DVDs you purchase shipped to other addresses, please

list the address(es) below along with the number of DVDs to be sent to each:

Qty __ Name ________________________________________________________

Address ____________________________________________________________

City ___________________________    State _________    Zip ________________

Qty __ Name ________________________________________________________

Address ____________________________________________________________

City ___________________________    State _________    Zip ________________

Qty __ Name ________________________________________________________

Address ____________________________________________________________

City ___________________________    State _________    Zip ________________

Allow approximately 2 weeks for delivery

Monies collected will be used for the Cemetery Restoration Project (repairing headstones, etc.)