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MAIL ORDER FORM


Print this page, fill in the information and mail to:

JRB Records
40 Carnegie Avenue

Huntington, NY 11743

Name: _____________________________________________________________

Address: ___________________________________________________________

City: __________________________ State: ____ Zip: ______ Country: __________

Phone: Required (____)____ - _________ Email Address: ______________________

Payment (circle one): Money Order | Visa | Mastercard | American Express | Discover

Name on Card ___________________________ Expiration Date ___/___ (month/year)

Card Number ___________________________________ CVC# __ __ __ (see below)

Signature __________________________________________________________
Credit card purchases only

Quantity
 Title
 Price
 SbTotal
 _______
CD-2001 A Composer's Christmas
 $ 9.99
 _______
 _______
CD-2002 Rachmaninoff Premieres
 $ 9.99
 _______
 _______
CD-2003 Ilan Guetta Plays Bach Electric
 $ 9.99
 _______
  CD-2004 Fingerbreakers
 $ 9.99
 
  CD-2030 One Hour To Madness & Joy  $ 9.99  
 _______
CD-3001 Christmas Straight Up
 $ 9.99
 _______
 _______
CD-3002 I Got The Blues For Christmas
 $ 9.99
 _______
  CD-3003 Scott Joplin Greatest Hits  $ 9.99  
  CD-3005 Stars & Stripes Forever  $ 9.99  
 _______
CD-3007 Dick Hyman At The Cookery (1973)
 $ 9.99
 _______
  CD-3008 Dick Hyman:Piano Pro Book  $ 19.99  
  CD-7001 Beyond The Manger  $ 9.99
  CD-7002 Storytime Favorites (3 cds - 4 hours)  $ 19.99  
 _______
CD-9001 The Fantastic World Of Christmas
 $ 9.99
 _______
 _______
CD-9002 The Fantastic World Of Liszt
 $ 9.99
 _______
 _______
CD-9003 The Fantastic World Of Gershwin
 $ 9.99
 _______
 _______
CD-9004 Fantastic Favorites
 $ 9.99
 _______
  CD-10001 Grand Russian Fantasy  $ 9.99
  CD-10002 The Classical Euphonium  $ 9.99
  CD-10006 A Cape May Christmas  $ 9.99  
 
8.7% sales tax NY residents only
--->
 _______
Fixed shipping&handling
--->
 $3.95
TOTAL COST (Payable to JRB Records)
--->
 _______

Allow 2 weeks for delivery.
We ship Media Mail within one day of the order.
Make money orders payable to JRB Records

THANK YOU FOR YOUR ORDER

--------------------------------

CVC: This is the number on the back of your card on the strip where you sign. It is a 3-digit number and may follow a longer number. On American Express Cards, it is a 4-digit number on the front of the card. We require it for added security.


Copyright ©1996-2006 JeRBil, Inc. of New York
All Rights Reserved