Order Form

ORDER FORM

Step 1: Please fill in the form fields below.

Step 2: Print this form to send with your payment.

Step 3: Submit this form electronically to put your order in process.

Step 4: Make your check or money order payable to Daffodil Music and send with this form to:
Sally Heckelman
11505 Daffodil Lane
Silver Spring, MD 20902

Name* Email Address*

Street Address*

City* State* Zip*

Phone*

Name of Child's School Teacher

CD: Put a Smile on Your Face	QTY	@ $15 each=
CD: Tap Your Feet to a Jewish Beat	QTY	@ $15 each=
Cassette: Tap Your Feet to a Jewish Beat	QTY	@ $10 each=
CD Special: Put a Smile on Your Face & Tap Your Feet to a Jewish Beat	QTY	@ $25 per set=

Orders of 10 or more receive a 10% discount		Less Discount
Maryland Residents Please Add State Sales Tax of 5%		MD Sales Tax 5%
Please Add Shipping & Handling: $2.00 for one, $3.25 for 2-4		Plus S&H
TOTAL ITEMS		TOTAL AMOUNT

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