Courthouse
Records - CD Order Form
Name:_________________________Phone:
(____)-______________
Street/Apt._______________________________________________
City:_____________________
State:________
Zip:________-_____
Email Address:___________________________
|
CD
Title
|
No.
of CD's
|
Amount
|
Jackie Frost - Calliope |
_______ @ $15.00 = | $________ |
|
Among
Friends 2001 - A
double CD
|
_______ @ $25.00 = | $________ |
|
Old School Freight Train............... |
_______ @ $15.00 = | $________ |
|
Modern
Groove Syndicate.............
|
_______ @ $10.00 = | $________ |
|
Danny
C's Musical Review................
|
_______ @ $15.00 = | $________ |
|
Modern
Groove Syndicate - Vessel
|
_______ @ $15.00 = | $________ |
| Shipping/handling: $2.50 for 1st and $1.00 for each additional……… |
Total
Shipping =
|
$________
|
|
Total
Enclosed for CDs:
|
$________
|
Other Merchandise |
Quantity |
Amount |
Modern Groove Syndicate T-Shirt - price includes shipping & handling. Please specify
size (S, M, L, XL) and color (ash or light blue) |
_______ @ $15.00 = | $________ |
| Total Enclosed for Other: |
$________ |
|
Total Shipping for all items = |
$________ |
| Total Enclosed for all items: |
$________ |
Check/MO
payable to Courthouse Records -
Total Enclosed
Mail this form to:
Courthouse Records
PO Box 8462 Richmond, VA 23226-0463
Mail this form to:
Courthouse Records
PO Box 8462 Richmond, VA 23226-0463
Thank
you for your order!
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