RANDOM STATIC ORDER FORM: DAPHNE LAWLESS

 _____________________________________________________________________________
|                                     |             |           |             |
| Item                                | Price (NZ$) | Quantity  | Total (NZ$) |
|_____________________________________|_____________|___________|_____________|
|                                     |             |           |             |
| CD: Undinal Songs - Daphne Lawless  | $20.00      |           |             |
|                                     |             |           |             |
| CD: Facing Image - Daphne Lawless   | $15.00      |           |             |
|_____________________________________|_____________|___________|_____________|
|                                                               |             |
|                                                Subtotal (NZ$) |             |
|_______________________________________________________________|_____________|
|                                                   |           |             |
| Postage                                           |           |             |
|                                                   |           |             |
| NZ/Australia Free, Rest of World $5.00            | 1 item    |             |
|                                                   |           |             |
| NZ/Australia Free, Rest of World $5.00            | 2 items   |             |
|                                                   |           |             |
| NZ/Australia Free, Rest of World $10.00           | 3 or more |             |
|___________________________________________________|___________|_____________|
|                                                               |             |
|                                                   Total (NZ$) |             |
|_______________________________________________________________|_____________|


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| Address for Delivery   |                                                    |
| (please print clearly) |                                                    |
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The New Zealand dollar is currently valued at approximately US $0.64. Payment
should be made by cheque or money order in NZ$. Cash in major foreign currencies
(notes only, no coins) to the same or greater value is also acceptable.

Make cheques payable to Random Static, and send to:

Random Static Mail Order
PO Box 10104
Wellington
New Zealand