ORDER FORM PRINT THIS FORM AND FAX TO 561-795-0228 OR MAIL TO: 700 E. RAMBLING DRIVE, WELLINGTON, FL 33414 Ship To: Name:______________________________________________ Address:____________________________________________ City:____________________State:_______Zip:_____________ Daytime Phone:(___)__________Evening Phone:(___)________

total

#cd's @ 14.95 each

# cassettes @ 10.95 each

Title

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Shipping & Handling 1-3 items = $4.00 4-6 items = $7.00 7-9 items = $9.00 10-12 items = $10.00 13- 15 items = $12.00

Payment Method: __________Check or Money order enclosed (Made Payable to "Mr. AL") __________Charge my _____visa _____mastercard _____Amex _____Discover Card Number:_________________________________________________ Expiration Date:______________________ Billing Address for Credit Card:____________________________________ Signature:_____________________________________________________ Thank You For Your Order!!!!

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