Jazz Record Center Order Form

Mail this Order Form to:    

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All information will be kept confidential and used only for your order.

Jazz Record Center
236 West 26th St
Room 804
New York, NY 10001
USA
- or -
FAX  to:  212.675.4504

Please print out this order form to mail in your order.

Your Name______________________________________________

Street______________________________________________________

City__________________________ State________ Zip code__________

Country_____________________________________________________

Daytime Telephone Number_____________________________________

Items_______________________________________________________

___________________________________________________________

___________________________________________________________

Method of Payment:
    [ ] check enclosed   (Make check payable to Jazz Record Center.)
    [ ] Credit Card     Check one:          [ ] Visa         [ ] MasterCard         [ ] Discover

         Card number: _____________________________  Exp. date:  Mo______ Yr______

         Signature:_________________________________________________________
                          (Required on all charge orders. Sign just as you would sign your credit card.)

  

Thank you!

(c) Copyright 1999 Jazz Record Center ALL RIGHTS RESERVED.