[DREAMS SCENE CD ORDER FORM]

  Date you are ordering .........................................
  Handle/Group (optional) .......................................
  E-Mail adress (optional) ......................................

  Full Name .....................................................
  Full Address ...................................................
  ...............................................................
  ...............................................................

  Quantity of CDs ...............................................
  Cost for the CDs (400bfr x Quantity) ..........................
  Shipping Costs ................................................
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  TOTAL COST (CD(s) + Shipping) .................................

  A few people outside Europe might be hit with a tax when ordering something
  from Europe. However this won't happened if one mark "GIFT" on the package.
  Under normal conditions we will not mark the GIFT box  on the custom label.
  However,  if you live in a strict country and feel we should check this box
  then you need to mark the box below.

  [ ] Yes. I consider the DREAMS CD a GIFT.

  * Payment by:

    [ ] Cash
    [ ] Check (from Belgium only!)
    [ ] International Money Order

  From where have you heard about DREAMS? (optional)
  ...............................................................

[END OF ORDER FORM]