Order form
 

"Music House: Musical Portraits"

Number of VHS copies ($15 each)      ___    Total =  ___

Number of DVD copies ($25 each)      ___    Total =  ___

Shipping ($2 per copy)                                     =   ___

Grand total                                                     =  ____

Your address:

_____________________
              Name  

__________________________ 
              Address

________________     ____   _________
           City                    State           Zip

Telephone: _____________________________

Email:        ______________________________

Please print this form and mail to:

M. Danziger
504 E. 88th St.  4B
New York, NY 10128

Thanks for your order!