Pat Garrett CDs & Cassettes Order Form

Print Order Form - Fill Out Form
Mail with payment to:
Pat Garrett Band, Rt. 78, Exit 7, Strausstown, PA 19559 USA
or FAX 610-488-1576 (Credit Card Payment)

Shipped to:
Name:___________________________________
Address:___________________________________
City:___________________________________
State/Providence:______________________Zip:_____________
Country:___________________________________
Date of Order ____/____/____

Album Title	Format CD or Cassette	Qty.	Price Each	Subtotal








Add $1.50 per item ordered for Shipping & Handling
International Orders Please Add $5.00 for Shipping
Add $2.00 for Credit Card Handling Charge
			Total Due

Method of Payment
____Check or Money Order enclosed
____Credit Card
(Select One) ____VISA ____ MC ____Disc
Card Number___________________________________
CID Number ________ (Located on the back of your card after the creditcard number)
Expiration Date ____/____/___
Signature (required)________________________________

Official Use Only
Date Received	___/___/___
Date Shipped	___/___/___

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