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KEITH-SUPPORT ORDER FORM (BLACK-ORIENTED)
Support my Projects for Black Advancement by
purchasing Black-oriented products
--domestic sales only. Also add, on this form, any
General Items
I offer and then receive a quote for all items combined.
Payment would be via PayPal or via mailed payment made out to to: Keith Anderson * PO Box 4051 * Bluefield, WV 24701 or to a street address.
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Name
*
Your answer
Member # (If you are a member of any of my organizations, include your Member #s here. If not, enter "N/A.")
*
Your answer
Email (If you are a member of any of my organizations, enter "You have it." If not, enter your email.)
*
Your answer
Domestic Shipping Zip. (Enter the domestic Zip Code where you want your order shipped.)
*
Your answer
Enter the Item #s of all items you want as well as any options available regarding such, then submit form and wait for quote.
*
Your answer
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