Bass Church ORDER FORM

QTY

Hungarian Gypsy Music vol. 1

@$15 each=

Jigs on Bass

@$15 each=

Two Swing Trios

@$15 each=

Dvorak Miniatures, op. 75a

@$15 each=

Shotgun Marriages

@$15 each=

Folk Settings From Beneath the Earth's Crust vol. I

@$15 each=

Bass Church Baseball Cap

@$15 each=

Washtub Bass

@$195 each=

SUBTOTAL

Shipping & Handling - in Continental USA $5.50 for first item, each add. item $.50 except Washtub Basses ship for $50 anywhere in Continental USA
AK, HI and international shipments email info@basschurch.com for price.

WA. State residents add 8.9% sales tax

TOTAL

SHIPPING INFORMATION:

Name

Address (for shipping)

City

State

Zip

Country

Phone

Email Address

BILLING INFORMATION:

Payment type

VISA

MASTERCARD

CHECK Enclosed (U.S. $ only)

Name on card (if different from above)

Billing address (if different from above)

Card Number

Exp. Date


Cardholder signature	___________________________________________________________

Mail to: The Bass Church ~ 9716 Phinney Ave N ~ Seattle, WA 98103 USA
or FAX: (206) 784-0725

ORDER OPTIONS:

1. Call us with your order and credit card information at (206) 784-6626.
2. Print the completed form with your credit card information and fax it to (206) 784-0725.
3. Print the completed form and mail it with your credit card information or check.

QUESTIONS? Call us at (206) 784-6626, or email orders@basschurch.com.