Name__________________________________________________________

Mailing Address__________________________________________________

City ________________ State_____ Zip__________ Phone#_____________

Game Request:*Shipping & tax included in price

Football 2011: 9-Man Championship - $25.00Football 2011: Class A Championship - $25.00Football 2011: Class AA Championship - $25.00Football 2011: Class AAA Championship - $25.00

Hockey 2012: Boys Semifinals - Fargo Davies vs. Fargo North $25.00Hockey 2012: Boys Semifinals - Grand Forks Red River vs. Grafton-Park River $25.00

20122012

2012 - Shilo Christian vs. Divide County2012 - Grafton vs. North Star2012 - Linton-HMB vs. Berthold2012 - Central Cass vs. Beulah2012201220122012

201220122012201220122012

2012 - Bismarck Shiloh Christian vs. New Town2012 - Grafton vs. Lakota-Adams-Edmore2012- Linton-Hazelton-Moffit-Braddock vs. Bishop Ryan2012 - Beach vs. Kindred2012201220122012

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Total DVDs Ordered:__________ Total Amount Due:__________

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Hockey : Girls Championship - Fargo South vs. Grand Forks $25.00Hockey : Boys Championship - Fargo North vs. Grafton-Park River $25.00

Boys Class B Basketball $25.00Boys Class B Basketball $25.00Boys Class B Basketbal $25.00Boys Class B Basketball $25.00Boys Class B Basketball : Semifinals - Shiloh Christian vs. North Star $25.00Boys Class B Basketbal l: Semifinals - Berthold vs. Beulah $25.00Boys Class B Basketball : 3rd/4th Place - Shiloh Christian vs. Berthold $25.00Boys Class B Basketbal l: Championship - North Star vs. Beulah $25.00

Boys Class A Basketball : Semifinal -Fargo Shanley vs. Wahpeton $25.00Boys Class A Basketball : Semifinal - Mandan vs. Grand Forks Red River $25.00Boys Class A Basketball : Championship - G.F. Red River vs. Shanley $25.00Girls Class A Basketball : Semifinal - West Fargo vs. Bismarck $25.00Girls Class A Basketball : Semifinal - Bismarck Century vs Fargo Shanley $25.00Girls Class A Basketball : Championship - Bismarck Century vs. W. Fargo $25.00

Girls Class B Basketball $25.00Girls Class B Basketball $25.00Girls Class B Basketball $25.00Girls Class B Basketball $25.00Girls Class B Basketball : Semifinals - Grafton vs. Shiloh Christian $25.00Girls Class B Basketball : Semifinals-Linton-Hazelton-Moffit-B. vs. Beach $25.00Girls Class B Basketball : 3rd/4th Place - Beach vs. Shiloh Christian $25.00Girls Class B Basketball : Championship - Grafton vs. Linton-Hazelton-M-B $25.00

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If you wish to purchase a DVD copy of one of the above games, please fill out this form andmail a check for the total amount due to:

KVLY-TV - Dub Request • PO Box 1878 • Fargo, ND 58107-1878

North Star vs. Napoleon-Gackle-StreeterLinton-HMB vs. Stanley-Powers Lake

Fargo Shanley vs. GraftonBismarck Century vs. Bismarck

(701) 237-5211(800) 450-5844

DVD RequestDVD Request