Music Today I LIVE IN INDIA AND WANT MY TITLES DELIVERED IN INDIA: ORDER FORM

ORDER FORM

If you live in the USA and and want Music Today titles delivered in the USA, this is the correct order form. Please use the print option on your browser to print this order form.You can also fax the completed form to Music Today at (212) 779-8206 in the USA, in case of payment by credit card.

India Today,
404 Park Avenue South
New York
NY 10016

Date____________

Please arrange to send me the following Audio Tapes/ Compact Discs:

Catalogue No	Title name	Audio Tapes(Nos)	CDs (Nos)	Value






Total

My particulars (In Capital letters)

Name ____________________________________________________________

Address_________________________________________________________

Country_________________________________

Tel number_____________________

My email_________________________________________________________

a)Cheque/ Draft no ______________________________________________________

drawn on _____________________________________________ (Name of Bank)

for US$ ____________________________________ in Favour of Living Media India Ltd.

b)Please charge my Credit Card

˜ Mastercard ˜ Visa

Credit Card no :˜ ˜ ˜ ˜ ˜ ˜ ˜ ˜ ˜ ˜ ˜ ˜ ˜ ˜ ˜ ˜

Card Members name ___________________________________________________________

Card members signature_______________________________________

Card expiry date ______________________________________________

Please deliver the cassettes and /or CDs ordered by me to:

Name _____________________________________________

Address____________________________________________

State _____________________________________

Zip _____________________________________

Tel number_________________________

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