 Robert Simon, Artistic Director Winston-Salem, NC - CD Order Form - |
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| FIRST NAME |
LAST NAME |
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ADDRESS |
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| CITY |
STATE ZIP |
| WORK PH |
HOME PH |
| Ship to (if different from above) | |
| SHIP TO NAME | |
| SHIP TO ADDRESS | |
| CITY |
STATE ZIP |
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Quantity |
CD Title |
Price |
Extension |
| Piedmont Wind Symphony Live, Vol I & II (2 CD set) | 20.00 | ||
| Piedmont Wind Symphony Live, Vol III (1 CD set) | 15.00 | ||
| Frederick Fennell Live with the Piedmont Wind Symphony (2 CD set) | 20.00 | ||
| A Piedmont Celebration (1 CD set) | 15.00 | ||
| Total CDs | Sub-Total | $ | |
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NC residents add 7% sales tax |
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Shipping
& Handling: $3.95 for first item; $1.00 each additional item to
same address. |
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Total (US Dollars Only) |
$ | ||
| TO PAY BY CHECK | mail
this form along with your check made payable to: The Piedmont Wind Symphony 526 S. Stratford Road, Winston-Salem, NC 27103 |
| TO PAY BY CREDIT CARD | either mail this form or fax to 336.761.8107 |
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o Visa o MasterCard o American Express o Discover |
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Card Number |
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| Expiration Date | |
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Name
as it appears on your card |
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Signature |
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FOR
GIFT ORDERS |
o
Check here if you would like to include a gift card. Message for gift card:
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