| To pay by check, print a copy of this page and fill out by hand. Mail this form with your check payable to RICHARD DOWLING. |
| CHECK ORDER FORM |
| Quantity |
| __________ |
| Total Number of CDs Ordered: |
| Total $ |
| Shipping Charge (refer to table below to calculate): |
| Grand Total |
| Domestic US Shipping |
| 1 2 3 4 or more |
| Quantity |
| Shipping Charge |
| $4.00 FREE FREE FREE |
| ________ |
| _______________ |
| _______________ |
| _______________ |
| Name |
E-mail
| Telephone |
| City, State, Zip |
| Address |
| Mail this order form and make check payable to: |
| RICHARD DOWLING 261 West 71 Street #3 New York, NY 10023-3743 |
| Thank you for your order! |
| Would you like your CDs autographed?* Circle one: YES NO |
| Gershwin |
| Chopin |
| Sweet LD |
| Joplin |
| Old NY |
| Rhapsody |
| Ragtime |
| Infinity |
| Quantity |
| __________ |
| Quantity |
| __________ |
| Quantity |
| __________ |
| Quantity |
| __________ |
| Quantity |
| __________ |
| Quantity |
| __________ |
| Quantity |
| __________ |
* If desired, indicate CD personalization here:
| $32 |
| $16 |
| $16 |
| $16 |
| $16 |
| $16 |
| $16 |
| $16 |
| Total before shipping charge: |
| Cocktails |
| Quantity |
| __________ |
| $20 |