Beltline Big Band - Big Band Bounce
CD Order Form

Name: _____________________________________ 

Phone #: __________________________________ 

Email:_____________________________________ 

Please pick one of the following two delivery options. 
You may get your CD directly from a band member when 
it becomes available or have it shipped (see below). 

[ ] CARE OF BAND MEMBER
    Band Member Name: _____________________ 

[ ] SHIP TO 
    Address: ______________________________ 
    City: _________________________________ 
    State: _________________ Zip: _________ 

Number of CDs desired: ____ X $15 = $ ______ 
Shipping*                           $ ______ 

Total                               $ ______ 

*Shipping cost is $3 for 1 CD, $4 for 2-5 CDs, and $5 for 6-10)

[ ] Paid 

Please make checks payable to Beltline Big Band. 

Orders are processed within 24 hours of receipt and shipped
via normal US postal delivery. For delivery outside of the
United States, or for other delivery options, please 
e-mail info@beltlinebigband.com or call 616-656-0670.
All prices are US dollars.

Print, complete and mail this form with payment to:

    Beltline Big Band
    5413 West Heathwood Drive
    Kentwood, MI 49512

Questions? Call Brenda @ 616-656-0670