| Name_______________________________________________________________________ |
| Address_____________________________________________________________________ |
| City________________________________ State______________ Zip__________________ |
| Day Phone____________________________ Email__________________________________ |
| PAYMENT(circle one) Check/MO (payable to HighNote Records) Credit Card |
|
Card#_________________________________________Ex Date(MM/YY)____________
Name On Card (print)_______________________________________________________
Cardholder's Signature_____________________________________________________ |
| Quantity |
Catalog# |
Artist / Title |
Unit Price |
Total |
OFFICE USE ONLY Date Received:
|
| Shipping Charges: $2.50 for 1 item $3.50 for 2 items $4.50 for 3 items $5.50 for 4 items Free shipping on orders of 5 or more! US orders only. All orders shipped via UPS. **NY State residents add 8.25% sales tax | |
| SUBTOTAL | |
| TAX** | |
| SHIPPING | |
| BALANCE DUE |