John DeWitt Music

20 Nevinwood Place
Huntington Station, NY 11746 USA
Phone/Fax 631.271.5742

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Mail or Fax to the address above. 
                                     ORDER FORM

Date _________________

Name ___________________________________    Ship To ________________________________

Address ________________________________    Address ________________________________

________________________________________    ________________________________________

City ___________________________________    City ___________________________________

State _________   Zip __________________    State _________   Zip __________________

Phone __________________________________    Phone __________________________________

  (When ordering Everyone Plays the Classics, please specify Treble or Bass Clef)

Cat. No.  Description                MIDI   CD   Cass  Quan  Unit Price  Total Price

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                 THANK YOU FOR YOUR ORDER.                        TOTAL  ___________

            Shipping:  $4.00 for the first item
              $1.00 for each additional item                   Shipping  ___________
            ($6.00/$2.00 outside Continental US)
     New York State Residents please add 8.5% Sales Tax                 ___________

            ________ Check/Money Order enclosed                 NYS Tax  ___________

            ________ Visa   ________ MasterCard             Amount Paid  ___________

       Card Number ___________________________________
                                                                   THANK YOU.
       Expiration Date ________

       Signature _____________________________________

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