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:(___)________
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total
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#cd's
@ 14.95 each
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# cassettes
@ 10.95 each
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Title
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__________
__________
__________
__________
__________
__________
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_________________
_________________
_________________
_________________
_________________
_________________
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________
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________
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________
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________
________
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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
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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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