California Aircheck Individual Tape Order Form

Print the this form and Fax  to (904) 548-9846 or Mail to: 85478 Sagaponack Drive - Fernandina Beach, FL 32034....You may pay for orders by check, money order, or credit card....

Be sure to fill out the address information below!

 

Please List the cassettes that you would like to order: (Please Print)

CURRENT ISSUE / Tape Numbers_________________________________@12.00 each $_________

PERSONALITY PLUS / Tape Numbers_____________________________@12.00 each $_________

SPECIAL ISSUE / Tape Numbers_________________________________@12.00 each $_________

CLASSIC ISSUE / Tape Numbers_________________________________@15.00 each $_________

ALL AC / Tape Numbers________________________________________@12.00 each $_________

ALL COUNTRY / Tape Numbers__________________________________@12.00 each $_________

ALL CHR / Tape Numbers_______________________________________@12.00 each $_________

ALL NEWS / Tape Numbers_____________________________________@12.00 each $_________

PROMO VAULT / Tape Numbers_________________________________@14.00 each $_________

SWEEPER VAULT / Tape Numbers_______________________________ @14.00 each $_________

VIDEO AIRCHECK /Tape Numbers_________________________________________ $_________

Overseas VIDEO orders - Specify whether you want PAL or NTSC videos!

Overseas Orders - Add $2.00 US Per Cassette and $5.00 US Per Videotape for Airmail Shipping

 

TOTAL...................................................................................................................................................$_________

 

COMPLETE THIS ADDRESS INFORMATION FOR ALL ORDERS

Ship Order to------Name__________________________________________________________

Address________________________________________________________

City,State,Zip________________________________________________________
..........................................................................................................................................................................................

Credit Card Orders..[ ] Visa ...[ ] Mastercard ....[ ] Discover

Name as it Appears on Card__________________________Sec. code from rear of card_____

 

Card Number______________________________________Exp Date_______________

 

E-mail address_____________________________ Amount to be Charged____________

 

Signature____________________________Phone number________________________

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