Shipping Address:
Name:
Address:
Phone:Email:
Sub Total:
Add 7.8% Sales Tax (Arizona residents only):
Add Charges for shipping & Handling:
Total Amount DUE:
( )Check Enclosed ( )Mastercard ( )VISA ( )American Express ( )Discover Card ID#:
Account No:




Expiration Date:
Name on the Card (Please Print)
Authorized Signature:




_________________________________________________________________________________________________
____________________________________________________________________________________________
________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Deluxe Wooden Music Stand