ORDER FORM

(Please, PRINT All Information)

Last Name________________________________ First Name__________________ Date____________
Street___________________________________________________________________________________
City________________________________ State_________ Zip_________ Country________________
Phone (Optional)_____________________ E-Mail ___________________________
  QTY.
 ARTIST / TITLE / DESCRIPTION
 CATALOG #
  UNIT PRICE
 AMOUNT
         
         
         
         
         
         
         
         
         
         
         
         
         
         
         
         
         
SUB-TOTAL:
 
SHIPPING:
(Overseas Specify)
( ) Air ( ) Surface
 
NY Sales Tax 8.25%:
 
INSURANCE:
 
GRAND TOTAL:

All Payments in US funds to the name of Ted Sterns

Send orders to:

Ted Sterns
13th Street Entertainment
338 East 13th Street, #4-D
New York, NY 10003


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