2324 Wyandotte Road Willow Grove, PA 19090 Tel: 215-659-0100 Fax: 215-659-1170

http://www.steveweissmusic.com info@steveweissmusic.com

BILLING ADDRESS SHIPPING ADDRESS (We recommend work-place delivery)

(Use name and billing address from Credit Card Statement if using Credit Card) Check if same as billing address NO PO BOXES
Name ______________________________________ Name _____________________________________
Organization _________________________________ Organization _______________________________
Address 1 ___________________________________ Address 1 __________________________________
Address 2 ___________________________________ Address 2 __________________________________
City ____________________ State _____________ City ___________________ State _____________
Country ______________ Zip/Postal Code _______ Country ______________ Zip/Postal Code ______
Telephone ( ______ ) _________________________ Telephone ( ______ ) _________________________
Fax ( ______ ) _______________________________ Fax ( ______ ) ______________________________
Email Address _______________________________
QTY MODEL # OR COMPOSER DESCRIPTION UNIT PRICE TOTAL

Domestic Shipping International Shipping Subtotal

UPS Next Day Air UPS Worldwide Express PA Residents Add 6% Sales Tax
UPS 2 Day Air Postal Priority (est. 6-14 Days)
UPS 3 Day Air Basic Shipping $9.95
UPS Ground Additional Shipping
TOTAL DUE

METHOD OF PAYMENT SHIPPING INFO

$9.95 – REGULAR UPS GROUND (IN THE 48 CONTIGUOUS STATES)
THERE ARE ADDITIONAL SHIPPING CHARGES ON: cases, hardware,
CC # ___________________________________ drum sets, drum heads 24” or larger, bongos, congas, timbales, snare drums, &
Visa, MasterCard or Discover Only large instruments.
Exp. Date ____/_____ 3 Digit CVV Code ______ Please check www.steveweissmusic.com for rate information.
(Last 3 digits from signature strip)
ALASKA, HAWAII, & PUERTO RICO - Please call for estimated rates.
Domestic Shipping - UPS Next Day, Two Day, & Three Day are available.
Signature ______________________________________ Call for estimated rates.
Check or Money Order Return Policy – Please check www.steveweissmusic.com policy.
School Purchase Order (Copy must be included with order) International Shipping - Please call for estimated rates and options.
International Warranty - No manufacturer or Steve Weiss Music, Inc.
warranty on any product sold outside the United States.