ORDER FORM - USA
Papa Panov - A Christmas Musical

1. Please click THE BUTTON to send us an email confirmation of your order. 
    This way we will receive advanced notice of your order and will have your package ready to go as soon as we receive your payment.
    Please add the name of the Purchasing Individual/ Group/ Institution to the body of the email, along with any other information that you wish to add. 
2. Please print this page, FILL it out and send IT with Your payment 
Name of Purchasing
Individual/Group/Institution		.......................................................................
Contact Name.......................................................................
Mailing Address (for delivery).......................................................................
.......................................................................
.......................................................................
.......................................................................
Telephone Number.......................................................................
Email address.......................................................................
Number of copies of 
Performance Package required:		[      ]
Payment Option
[ ]$105.00 + $10.00 (s+h) each (US dollars)
(postmarked on or before 31st August 2007)

[ ] $115.00 + $10 (s+h) each (US Dollars)
(postmarked after 31st August 2007)

[ ] $120.00 + $12 (s+h) each (Canadian Dollars)
  
 
Payment type:

[ ]

Check

[ ]

Money Order
Check/Money Order amount: $....................................................................

 
Special Requests?.......................................................................
Please tell us how you heard about
"Papa Panov - A Christmas Musical"		.......................................................................
.......................................................................
.......................................................................
  
Please make check or money orders payable to
"Alex Robinson - 4Music"

Send this form and payment to
ALEX ROBINSON - 4MUSIC
1088 SECORD AVENUE,
OTTAWA, ON, K1H 8C 8
CANADA

Please allow 14 days for delivery.