the-music-connection.com Fax/Mail Order Form

the-music-connection.com FAX/MAIL Order Form
Simply print out this page, fill out and Fax or Mail.
Fax to: (919) 217-4795
Mail to: the-music-connection.com, 2548 Oakes Plantation Dr., Raleigh, NC 27610 USA

NAME:
Company:
Address:
City, State, Zip:					Country:
Phone:				E-mail:
SHIP TO:
Company:
Address:
City, State, Zip:					Country:
Item Number	Item Description			Quantity	Unit Price	Extended Price







					Subtotal
					NC only 7% Tax
Charge My:	MasterCard	VISA	Check or Money Order		Shipping
Credit Card Number:
Expiration:					Total
Name as on Card:
Signature:

Prices, Specifications, and availability subject to change without notice