Please send me _______ copy(s) of A Time to Dance in

for $13.95 each

plus $3.95 each shipping and handling. USA only.

Name_____________________________________

Address___________________________________

City_____________________zip code_______________

Please send with check or money order to:

Diana Lesire Brandmeyer

332 Centerville Ave.

Belleville, IL 62220

I would like it autographed to: _______________________

Thank you!

Diana Lesire Brandmeyer