Pentagram

 

 

ORDER FORM FOR DARBUKA /  KAV HATEFER CD / BOOK

 

ITEM NAME                PRICE PER UNIT              NUMBER OF ORDERS              AMOUNT DUE

 

Darbuka                                                                             195.00 $-------------------------        ---------------------------------          $ 

 

Shipping for darbuka                                                       43.00 $-------------------------        ---------------------------------          $

 

Extra head                                                                           12.00 $-------------------------        ---------------------------------          $

 

Kav Hatefer CD + shipping                                               15.00 $-------------------------        ---------------------------------          $

 

“Art of Middle Eastern Rythms” Book +6 CD's          72.00  $-------------------------        ---------------------------------        $

 

                                                                                                                                                                                       Total             $

 

1.       Items will remain in “Pentagram’s” ownership until payment is settled.

2.       This order will remain valid for 30 days from when it is received.

3.       All items will be shipped by EMS airmail.

4.       Please allow 3 weeks for delivery.

 

Please fill out this next information (in print) :

 

First and Last Name + Middle Initial __________________________________________________

 

Company  Name                                            Contact Representative_________________________                                               

 

Billing Address____________________________________________________________________                                                                                                                                

 

Phone #____                                             Fax  # ____________________

 

Email:______________________________

 

Mailing Address ( if different than above)_______________________________________________

 

Type of Credit Card_________________Credit Card #________________________________

 

Valid Until__________

 

 

 

 Your Signature________________________________

 

 

 

 

Other Comments or Requests_________________________________________________________________________

 

 

 

 

 

Fax this form to:   972 3 9032938

 

or mail to:   Y.A. Ametis

                    5   Yekutiel Adam St.

                    Kfar Saba, Israel.

(tel) 972 3 9032911