BluesTone Order Form

Order Form for BluesTone Music Rolls (updated 1-1-2006)Send to: Rob DeLand / BluesTone Music Rolls 485 Gatewood Lane / Grayslake, IL 60030 Email to: robdeland@bluesrolls.com Date:______________________________

Ship to:Name: ______________________________ Address: ______________________________ ______________________________ City, State: ______________________________ ZIP: ______________________________

email address:______________________________ Roll # Title Quantity Price _______ _______________________ _________ ________ _______ _______________________ _________ ________ _______ _______________________ _________ ________ _______ _______________________ _________ ________ _______ _______________________ _________ ________ _______ _______________________ _________ ________ _______ _______________________ _________ ________ _______ _______________________ _________ ________ _______ _______________________ _________ ________ _______ _______________________ _________ ________ _______ _______________________ _________ ________ _______ _______________________ _________ ________ _______ _______________________ _________ ________ _______ _______________________ _________ ________ _______ _______________________ _________ ________ _______ _______________________ _________ ________ _______ _______________________ _________ ________ SHIPPING: ________ TOTAL: ________ Please see www.bluesrolls.com for ordering and shipping information. Please make checks payable to Robert DeLand in U.S. funds drawn on a U.S. bank. Thank you for your order! I will ship it as quickly as possible.

For shipments within the U.S. send $5.00 for the first roll, and $.50 for each additional roll. If you order six or more rolls, shipping (in U.S.) is free.

For shipments to Canada send $6.00 for the first roll and $1.50 for each additional roll (for surface parcel post). If you order six or more rolls, cut these shipping rates in half.

For shipments outside the U.S. & Canada send $11.00 for the first roll and $2.00 for each additional roll (for surface parcel post). If you order six or more rolls, cut these shipping rates in half.