FAX
Date:                      Time:

To: Philomel Records, Inc.
Phone: 1-800-225-1228 or 1-858-457-0463 (from within U.S.)
00-1-858-457-0463 (from outside U.S.)

FAX: 1-858-453-4763 (from within U.S.)
00-1-858-453-4763 (from outside U.S.)

Please send CD(s):

Name:
Phone:
Name as it appears on card:
Method of Payment: Visa [ ] MasterCard [ ] Am Express [ ] Discover [ ] EuroCard [ ]
Card#:                                                   Expiration date:

Street Address:
City:                                                    State (or Province):               Zip code:
Country:

Total Amount in $:

• Each Compact Disc come packaged together with one booklet.
  Price for one CD:
  • Within the U.S. - $14.95, + $4.95 for shipping (first class) and handling
  • Outside the U.S.- $14.95, + $9.95 for shipping (air mail) and handling
    
• Price for both CDs (two CDs with booklets):
  • Within the U.S. - $24.95, + $4.95 for shipping (first class) and handling
  • Outside the U.S.- $24.95, + $9.95 for shipping (air mail) and handling
  
  Signature: ________________________________