Fairmont ElementaryThe Little Mermaid, Jr. DVDs"*" indicates required fieldsParent/Guardian Name* First Name Last Name Student Name* First Name Last Name Cast* Dinglehopper SnarfblattEmail Address* PhoneStudent's Teacher*Little Mermaid, Jr. Products* DVDs ($30)Please check the boxes of all products you're interested in purchasing.DVDsDVDs Quantity Price: $30.00 Quantity How many DVDs would you like to purchase?Additional ShirtsOne free child's size shirt is included in your participation fee. Use the options below to order ADDITIONAL shirts.Crew Neck - Youth Small Quantity Price: $8.00 Quantity Crew Neck - Youth Medium Quantity Price: $8.00 Quantity Crew Neck - Youth Large Quantity Price: $8.00 Quantity Crew Neck - Adult Small Quantity Price: $8.00 Quantity Crew Neck - Adult Medium Quantity Price: $8.00 Quantity Crew Neck - Adult Large Quantity Price: $8.00 Quantity Crew Neck - Adult Extra Large Quantity Price: $8.00 Quantity Crew Neck - Adult 2XL Quantity Price: $8.00 Quantity Crew Neck - Adult 3XL Quantity Price: $8.00 Quantity V-Neck - Adult Small Quantity Price: $10.00 Quantity V-Neck - Adult Medium Quantity Price: $10.00 Quantity V-Neck - Adult Large Quantity Price: $10.00 Quantity V-Neck - Adult Extra Large Quantity Price: $10.00 Quantity V-Neck - Adult 2XL Quantity Price: $10.00 Quantity V-Neck - Adult 3XL Quantity Price: $10.00 Quantity Additional Break-a-Leg MessagesOne free Break-a-Leg message is included in your participation fees. Use the options below to order ADDITIONAL messages.Sample Message: You were amazing! You make us so proud. Love, Gramma & PoppaAdditional Break-a-Leg Messages Price: You can purchase up to three additional messages.Message Quantity*Please enter a number from 1 to 3.Break-a-Leg Message #1Break-a-Leg Message #2*Break-a-Leg Message #3*Friends & Family AdsEmail your message and ad graphic to Emily Bent at emilybent@sbcglobal.net.1/4 Page Ad Quantity Price: $25.00 Quantity 1/2 Page Ad Quantity Price: $50.00 Quantity Full Page Ad Quantity Price: $100.00 Quantity Black & White Business AdsEmail your message and ad graphic to Emily Bent at emilybent@sbcglobal.net. To inquire about color cover ads, email Mandie Smith at mandie.smith24@gmail.com.1/4 Page Business Ad Quantity Price: $30.00 Quantity 1/2 Page Business Ad Quantity Price: $50.00 Quantity Full Page Business Ad Quantity Price: $100.00 Quantity Payment InformationOnline Processing Fee* Price: Total Due Billing Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Zipcode Secure Payment Details*PhoneThis field is for validation purposes and should be left unchanged.
