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Lou Capece Music Distributors
2555 N. Jerusalem Road, East Meadow, NY 11554
800-321-5584 • 516-221-5596 • Fax 800-573-3630 www.LouCapeceMusic.com Marketing@LouCapeceMusic.com
BILLING INFORMATION
Contact Name _______________________________________ Company ___________________________________________ Address ____________________________________________ City ________________________________ State__________ Zip _______________________ Country _________________ Phone ____________________ Fax_____________________
SHIPPING INSTRUCTIONS (If different from billing address) Ship To_____________________________________________ Address ____________________________________________ City ______________________ State____________________ Zip _______________________ Country _________________ Shipping
Standard Expedited Next Day Ground 2-3 Days Special
QTY.
ITEM #
DESCRIPTION
METHOD OF PAYMENT
Check Enclosed
COD Visa MasterCard Discover American Express
Name as Shown on Card _____________________________________________________________________________________________
Credit Card # _________________________________________________ Exp. Date _____________________ CVV Code _____________
Lou Capece Music Distributors 800-321-5584 • 516-221-5596 • Fax 800-573-3630 | Order online: loucapecemusic.com 141
Order Sheet
