Order Form

Please use this form if you would like to print and mail or call Holley Music with your order ready 1-800-526-9441
NOTE: US funds only, No Cash, Checks with printed name, Service Charge $20.00 on returned checks.

Please provide the following contact information:

Name

Street address

Address (cont.)

City

State/Province

Zip/Postal code

Country

Work Phone

Home Phone

FAX

E-mail

Please provide the following ordering information:

QTY CAT# FORMAT DESCRIPTION COST

Shipping see chart below

NO International Shipments

BILLING TOTAL

Credit card

Cardholder name

Card number

Expiration date

SHIPPING IF DIFFERENT FROM ABOVE

Street address

Address (cont.)

City

State/Province

Zip/Postal code

-Gift Certificates-
We will send a gift certificate, in any amount, along with
our brochure, to you to present to a lucky baseball fan
-or- mail it directly to the recipient for you.

Shipping & Handling Chart (Priority Mail)
Merchandise Total Range	Shipping Charges	Merchandise Total Range	Shipping Charges
$1.00 -34.99	$6.95	$55.00 -64.99	$ 9.95
$35.00 -44.99	$7.95	$65.00 -84.99	$10.95
$45.00 -54.99	$8.95	$85.00 -& up	$11.95

Name
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
Work Phone
Home Phone
FAX
E-mail

	Shipping see chart below
	NO International Shipments
BILLING		TOTAL
Credit card
Cardholder name
Card number
Expiration date

	SHIPPING IF DIFFERENT FROM ABOVE
Street address
Address (cont.)
City
State/Province
Zip/Postal code

Order Form

Last revised: