Independence 72 Media Purchase Independence 72 Media Order Form: Purchase additional copies below by entering the Media Type/Quantity. After you complete the form, you will be redirected to PayPal to complete your order. Available formats include: Blu-Ray $22 / Event DVD $10 / Photo CD $10 ($10 shipping & handling is included in the price) Blu-Ray $22 Blu-Ray $22 Blu-Ray Quantity: Event DVD $10 Event DVD $10 Event DVD Quantity: Photo CD $10 Photo CD $10 Photo CD Quantity: Contact Information: First Name (required) Last Name (required) Contact Number (required) Email (required) Mailing Address: Address #1 (required) Address #2 City (required) State (required) —Please choose an option—AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code (required)