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Dear Customer, after filling out and submitting this order form

you will instantly receive a confirmation

summarizing all data successfully submitted to us.
Please, print it for your future reference.

	ORDER FORM
	Agencja Fonograficzna "SKOK Music & Film", 221 Provender Ave., K1K 4N8, Ottawa, Ont., CANADA Customer Service: tel. (613) 741 0613, fax: (613) 741 5954, e-mail: skok@polishmusic.ca

home	Our business hours are: Mon - Fri, 10:00 a.m. - 5:00 p.m. Eastern Standard Time

Please note: our ordering system is manual and all items of your interest (CDs / DVDs) have to be manually entered (typed down or pasted in) in the comment section of this form, see the comment section at the bottom of the page

To correctly order CDs please specify the following in the comment field:

	1. artist name and album title
	2. catalogue number (code) attached to the CD
	3. quantity
	4. shipping method for your parcel (shipping methods and related costs for specific regions available at: how-to-order page)

To correctly order DVDs please specify the following in the comment field:

	1. DVD title and the director's name
	2. catalogue number (code) attached to the DVD
	3. quantity
	4. shipping method for your parcel (shipping methods and related costs for specific regions available at: how-to-order page )

Shipping costs of combined parcels (CDs and DVDs in one package) are calculated according to the following rule:
standard DVD counts as 1.5 standard CDs, multiples are calculated accordingly.

Your full name:

( full first and last name of ordering person,

including salutation, e.g. Mrs. Joanna Smith )

Shipping address:

( street address, building name, etc. )

City:

Province/State/Bundesland:

( full name )

Postal code/Zip:

Country:

Phone:

Fax ( if applicable ):

E-mail:

Please note: The name of the ordering person has to be the same as the name of card holder

Payment method:

Cardholder name:

( name of person using the card, not the bank,

exactly as appears on the card )

Cardholder address - line 1:

( street address, building name, etc. )

Cardholder address - line 2:

( city, postal code, province/state, country )

Credit Card number:

Expiry date: -

On your credit card statement the charge will come from Skok Music & Film

COMMENT SECTION:

Enter your CD / DVD selections, shipment method of your choice and comments below :

For a variety of shipping methods and related costs for a specific country or region, please, refer to:

- how-to-order CD page - when ordering CDs

- how-to-order DVD page - when ordering DVDs.

Shipping costs of combined parcels (CDs and DVDs in one package) are calculated according to the following rule: 1 standard DVD counts as 1.5 standard CDs, multiples are calculated accordingly.

our E-mail: skok@polishmusic.ca