DIANE HUBKA  -  CD ORDER FORM Click to  
Print this form and send with your check or money order

Ship to:
Name:        _______________________________________________
Address:     _______________________________________________
Address:     _______________________________________________
                 _______________________________________________
City:   ______________________   State:  _____   ZIP:  __________
Telephone:   ___________________   Email:  ________________________


Price Includes Shipping & Handling to the US:

 CD - Diane Hubka Goes to the Movies         Quantity: ________ @ $ 15.00
 CD - You Inspire Me                                     Quantity: ________ @ $ 15.00
 CD - Look No Further                                   Quantity: ________ @ $ 15.00
 CD - Haven't We Met?                                  Quantity: ________ @ $ 15.00

Japanese Release with bonus track:
 CD - I Like It Here / Live In Tokyo                Quantity: ________ @ $ 20.00
 CD - You Inspire Me + 1                               Quantity: ________ @ $ 20.00

US orders:     Total # of CDs @ $ 15.00   ______ Total Price:  __________
                      Total # of CDs @ $ 20.00   ______ Total Price:  __________
                                                  TOTAL AMOUNT INCLUDED  _________

Canada & International Orders - email info@dianehubka.com for actual sh & h


Please make check or money order payable to:  Diane Hubka.

Mail to:

Diane Hubka
DHJazz Productions
PO Box 69823
Los Angeles, CA 90069-0823