Print form, complete and mail to:
WEL's Band Music
#355
922 S. Woodbourne Road
Levittown, PA 19057-1001

Ship to:

_____________________________________
(Name)
_____________________________________
(Address)
_____________________________________
(City/State/Zip Code)

 Bill to:

_____________________________________
(Name)
_____________________________________
(Address)
_____________________________________
(City/State/Zip Code)
____________________________________
(Phone No.)
ITEMS ORDERED  
Qty
Title
Series
Unit PriceEach
Total Price
  "A" Series Complete Set of (10) Songs  
$300.00
  
         
  "B" Series Complete Set of (10) Songs  
$300.00
  
         
  Individual Songs (List songs by name and indicate series)  
$35.00
  
         
         
         
         
         
         
         
         
         
         
         
 
(SHIPPING AND HANDLING)
    
$12.00
 
GRAND TOTAL
      
Purchase Order #: ______________
Tax Exempt #: _________________
Authorized Signature: ___________________________
Date: ___________________________