James Moody Mail Order Form

| Merchandise |

Please Print and fill out the form, with the respective merchandise that you are interested in purchasing and mail to:
7650 Lake Adlon Drive San Diego, CA 92119-2518.
Enclose your check made payable to LMM Music

Ship To:

                Name   ______________________________________

Street Address   ______________________________________

    Apartment or
   Suite Number  _________         

      City _________________   State ________   Zip __________

            Country   _______________________________________

Phone Day  (       ) _____________    Phone Evening (       ) _____________

                Email   ______________________________________

Description Qty. Price Total
1._______________________________ ____ $________ $________
2._______________________________ ____ $________ $________
3._______________________________ ____ $________ $________
4._______________________________ ____ $________ $________
5._______________________________ ____ $________ $________
6._______________________________ ____ $________ $________
7._______________________________ ____ $________ $________
8._______________________________ ____ $________ $________
9._______________________________ ____ $________ $________
Sub Total: $__________
Sales Tax (CA. residents only) 7.5%: $__________
Shipping and Handling 1 - 3 items $4.00: $__________
Total: $__________