*************************************************************************** Official MusiQuest Order Form *************************************************************************** Personal Information... First & Last Name ________________________________________ Mailing Address ________________________________________ City, State, Zip ________________________________________ Phone Number ________________________ Age ___________ Email Address ________________________________________ (please include so we can confirm your order and payment) I heard about MusiQuest from _____________________________ This order is (a gift / for self) ________________________ *************************************************************************** Personal Taste in Music... (Please check any answer that applies to you) ___ Rap (Coolio or Ice Cube) ___ Rock (Live or Aerosmith) ___ Pop/Dance (Madonna or Mariah Carey) ___ Soft Rock (Michael Bolton or Gloria Estefan) ___ R&B (Brian McKnight or The Fugees) ___ Alternative (Green Day or MC900ft Jesus) ___ Contemporary Jazz (The Rippingtons or Dave Cos) ___ Metal (Metallica or Alice In Chains) ___ Country (Randy Travis or Vern Gosdin) ___ Ethnic (African or Irish etc.) ___ Classical (Beethoven or Mozart) ___ Oldies (Chubby Checker or The Isley Brothers) ___ Other (Please specify) ______________________ *************************************************************************** Please mark the quantity and add up the amount of each item you wish to purchase... ____________________________________________________________ | | | Amount | | | Cassette Title | QTY |per item| SubTotal | |__________________________________|_____|________|__________| | | | | | | Lost Pop Hits Of The 80s | | $7.00 | | |__________________________________|_____|________|__________| | | | | | | Lost Pop Artists Of The 80s | | $7.00 | | |__________________________________|_____|________|__________| | | | | | | Custom Cassette (up to 20 songs) | | $12.00 | | |__________________________________|_____|________|__________| | | | | | | Custom CD *new* (up to 15 songs) | | $30.00 | | |__________________________________|_____|________|__________| | | | | | S&H OF $3.00 FOR EVERY 2 ITEMS -> |Shipping| $____.00 | |________________________________________|________|__________| | | | | | PLEASE PUT TOTAL DOLLAR AMOUNT HERE -> | Total | $____.00 | |________________________________________|________|__________| *************************************************************************** If ordering a Custom Cassette or CD, please select the names and artists of the songs you would like to receive. We give you the chance to list up to 20 (or 15), however since cassettes are limited to 90 minutes, please keep in mind that not all songs may be included. That is why we ask that you list the songs in order of preference so that the ones you want the most do get on the cassette or CD. Songs are selected in order of preference, then availability. _________________________________________________________________________ | | | | | | Song Title | Artist | Song Title | Artist | |__________________|_________________|__________________|_________________| |1 | |11 | | |__________________|_________________|__________________|_________________| |2 | |12 | | |__________________|_________________|__________________|_________________| |3 | |13 | | |__________________|_________________|__________________|_________________| |4 | |14 | | |__________________|_________________|__________________|_________________| |5 | |15 | | |__________________|_________________|__________________|_________________| |6 | |16 | | |__________________|_________________|__________________|_________________| |7 | |17 | | |__________________|_________________|__________________|_________________| |8 | |18 | | |__________________|_________________|__________________|_________________| |9 | |19 | | |__________________|_________________|__________________|_________________| |10 | |20 | | |__________________|_________________|__________________|_________________| In the event that a particular music selection is not available, a refund of (8 / amount of songs ordered) cents per unavailable selection will be given. For example, if you order 20 songs, you would get back 40 cents per each unavailable selection. If there are no songs available you will receive a full refund. If one or more is available, you will receive your cassette with the available selections. Sorry, shipping and materials costs will not be refunded in that case. Although we offer the availability of "any songs you want", there is no guarantee that a particular title may be available, especially titles that do not fit within the range of the our specialties. MusiQuest specializes in Pop, Top 40, and Rock hits from the 70s to the 90s. We also have much Adult Contemporary, and popular oldies. Please email MusiQuest@customized.com for details on the availability of an uncertain title, or for general questions. *************************************************************************** Please send this form completed along with payment to Brian Florence 1902 4th Ave Apt #3 Scottsbluff, Nebraska 69361 Be sure to include Shipping and Handling charges with your payment *************************************************************************** MusiQuest Official Order Form Revision 6 (C)1999 Brian Florence