Capcan Music - General Order Form, Fax or Mail-In - Canadian, CD, distribution, independent, recordings

	General Order Form Fax or Mail-in
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Please Print this form to complete, then fax or mail-in your order for credit card security. Thank you. Please see individual artist pages for pricing and product identification number!

1. INDICATE QUANTITY AND ITEMS ORDERED
Qty.	Item	Item No.	CD/ Cass.	Price	Total
1	Example: "Dicey Reilly" Celtic Folk Music	CMD444	CD	15.95

2. INDICATE METHOD OF PAYMENT		Sub Total
Check/Money Order payable to Capcan Music Distribution		Discount (10% 3 or more)	$
VISA	MasterCard	Shipping (CDs $4.00 1^st item) (Videos/DVDs 1st item $8.00) ($1.00 each addt'l item)	$
-	-	-	.
Card # - - -		Overseas Orders add $5.00	$
Expiry Date: _______/_______		Sub Total	$
Name on Card:		BC (only) 7% sales tax	$
Signature: X		GRAND TOTAL	$

3. PLEASE PRINT CLEARLY	SHIP TO: (If different than No.3)
Name:	Name:
Address1:	Address1:
Address2:	Address2:
City:	City:
Prov/State:	Prov/State:
Zip/Postal Code:	Zip/Postal Code:
Country	Country
Tel: (for confirmation)	.
Fax:	.
Email:	.

Capcan Music Order-Line Fax# (604) 940-1705

Capcan Music Distribution www.capcan.com
Mail in your orders or fax to:
10-5053-47th Avenue, Delta, BC V4K 1R2 Canada Tel: 604-940-0147 / Fax: 604-940-1705
Email and Web Master: pchipman@telus.net