| Order
Form
Please print out this form, fill out your order and mail or
fax to: Harpsichord Clearing House 9 Chestnut Street Rehoboth, MA 02769 TEL: 508-252-4304 or FAX: 508-252-4397 We accept Visa, Mastercard and Novus/Discover, payable in US Funds, drawn on a US Bank. |
| _______________________________________________________ | $________ |
| _______________________________________________________ | $________ |
| _______________________________________________________ | $________ |
| _______________________________________________________ | $________ |
| _______________________________________________________ | $________ |
| _______________________________________________________ | $________ |
| _______________________________________________________ | $________ |
| _______________________________________________________ | $________ |
| _______________________________________________________ | $________ |
| Subtotal | $________ |
| Massachusetts residents 5% tax | $________ |
Shipping & handling charges (continental U.S., includes insurance on declared value) |
|
| For shipments between $1.00 and $24.99 -------------------------------$6.00 | $________ |
| For shipments between $25.00 and $124.99----------------------------$12.50 | $________ |
| For shipments between $125.00 and $500.00--------------------------$25.00 | $________ |
| Inquire for overseas shipment | |
TOTAL |
$________ |
Credit card (Visa, Mastercard,Novus/Discover) #___________________________________ |
|
| Expiration
date ________________________ |
|
| Ship to: | |
Address
|
|
| Phone | |
| Fax |
|
Special instructions for handling, delivery, etc.
|
|
