To place an order, print this form, complete the
following information and mail to:
Helen Jones Gospel Piano Studio
8414 Fallsdale Drive
Charlotte,
NC 28214
Phone: 704-399-5040
Please Print Clearly
| Sold To: | Shipping Address: (if different from sold to) | ||
| Name | _______________________ | Name | _______________________ |
| Street Address | _______________________ | Street Address | _______________________ |
| City, State, Zip | _______________________ | City, State, Zip | _______________________ |
| Telephone Number | _______________________ | Telephone Number | _______________________ |
| Email Address | _______________________ | Email Address | _______________________ |
Order Information:
| Quantity |
Title |
Total Price |
| ________
________ ________ |
Looking at Chords @ $17.95 | $____________ |
| Looking at Chords Companion DVD @ $15.00 | $____________ | |
|
Book/DVD Combination @ $30.95 |
$____________ | |
| Shipping/Handling ($5.00 per Book/DVD) | $____________ | |
| International Shipping/Handling ($7.00 per Book/DVD) | $____________ | |
|
|
Sales Tax (NC residents only) add 6.5% | $____________ |
| TOTAL | $____________ |
______________________________________________ Signature