Print this order form:
Name:_________________________________ Phone:____________________ Address:_________________________________________________________ City:____________________ State/Province:__________ Postal Code__________ Country:______
| Item Description | Quantity | Price | Extended | ||
|---|---|---|---|---|---|
| _______________________________________ | _______ | $ | _______ | $ | __________ |
| _______________________________________ | _______ | $ | _______ | $ | __________ |
| _______________________________________ | _______ | $ | _______ | $ | __________ |
| _______________________________________ | _______ | $ | _______ | $ | __________ |
| _______________________________________ | _______ | $ | _______ | $ | __________ |
| _______________________________________ | _______ | $ | _______ | $ | __________ |
| IL residents add 6% sales tax. | $ | __________ | |||
| Shipping - $3.00 per item, or $4.00 for book and CD together | $ | __________ | |||
| ---------------------------------------------------- | --------- | -- | --------- | -- | ------------- |
| Total | $ | __________ | |||
Credit card information: Card type (circle one): Discover Mastercard Visa Card number: ____________________________________ Expiration date: __________ Name on card: ___________________________________ Signature: ______________________________________
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Terri Tunes company 5165 Jenkins Drive South Beloit, IL 61080 USA |