The Haining Family
Order Form

Please print and fill out this form, make your check or
money order payable to "Countryside Enterprises", and send to:

The Haining Family
24126 - 239th Street
Fergus Falls, Minnesota  56537


             Name:  ________________________________________

   Street Address:  ________________________________________

                    ________________________________________

 City, State, Zip:  ________________________________________


 Please send me the following:

 _____ copies of "Sunset Waltz" at $15.00 each      CDs:  $ _________

       Shipping & Handling $2.00 per CD             S/H   $ _________

                                                   Total: $ _________