Dave Fromer Music . . . . . . . . . . . . . . . . . . . . . . . . . BACK

CD Order Form:

This form is to assist you in ordering the CD "Shake A Hand".
Please feel free to use it for US Mail or fax ordering of the CD.
For phone or Fax ordering you must use a credit card.
If you choose to use US mail you can use either a credit card or check.

Name: ______________________________________________
Address: ____________________________________________
City: _____________________________ State: ___________ Zip Code: ___________

Phone Number: ____________________________________________
(Optional) To be used only if we need to contact you with a problem
E-mail: ________________________________________________________________
(Optional)   If you wish to be notified of new releases or upcoming appearances of Dave Fromer Check Here: ________

Shake a Hand CD:   Number of CD's _______ X   $15.00 =    _________________
CA resident sales tax:    "       of CD's _______ X    $ 1.10 =    _________________
Shipping & Handling:                                     For one CD  =    $1.95
                                                                     For 2 or more  =    $3.95  
                                                                                    Total:     _________________
Make Checks Payable to: "Dave Fromer Music"

Credit Card Type: ___________________________(Visa or Master Card Only)
Credit Card Number: _______________________________________________
Name as it appears on the card: _______________________________________
Expiration Date as it appears on the card: _______________________________
Zip Code for billing of this credit card: _________________

Shipping Information, if different than above address:
Name: _______________________________________________________________
Address: _____________________________________________________________
City: ______________________________ State: ________ Zip Code: ____________

Mail To:   Dave Fromer Music                        
               147 Elm Avenue
                Mill Valley, CA 94941

Fax To: (415) 383-1068                                  

Please know we respect your privacy and that we do not share any information with anyone for any reason.