Print Order Form


Printable Order Form / Purchase Order Form
SHIP TO:	BILL TO:
Name: _______________________	Name: _______________________
Co. Name: _______________________	Co. Name: _______________________
Address: _______________________	Address: _______________________
Address: _______________________	Address: _______________________
City:___________________ State:___________	City:___________________ State:__________
Zip:_____________ Country:_______________	Zip:__________ Country:_________________

PAYMENT METHOD:
Check#:_______ Amt. enclosed: $___________	Phone: (____) -______-________
Card type: Mastercard, Visa, Discover	Fax Number: (____) -______-________
Card number: ____________________________ Exp Date: CCV#:	Email Address: _____________________

Just print out this form and fill in the details and then mail it in. Thank You.

Make Check payable to Victrola Repair Service / 206 Cliff St. / St. Johnsbury, VT 05819

Note: You Must Call for Shipping Prices
.

Please supply the following items
Quantity	PRODUCT DESCRIPTION	Retail Price	TOTAL AMOUNT
.	.	$	$
.	.	$	$
.	.	$	$
.	.	$	$
.	.	$	$
.	.	$	$
.	.	$	$
.	.	$	$
.	.	$	$
.	.	$	$
.	.	$	$
.	.	$	$
Note: You Must Call for Shipping Prices. If you're unsure of the exact shipping amount, please call before sending the order to us. Amounts due will be billed and must be paid prior to shipping.		$	$
		$	$

APPROXIMATE shipping and handling charges: Order Total : Shipping Total	SUBTOTAL	$
	Shipping & Handling charges	$
$0 to $10 : $2 $10 to $20 : $3	VT addresses/residents add 6%	$
$20.01 to $30 : $5 $30.01 to $40 : $6	TOTAL DUE	$
$40.01 to $60 : $7 $60.01 + : $8 and up		.

NOTE: ADDITIONAL SHIPPING:

Thank You

Some products due to their size and weight require additional shipping fees. The same goes for packages that require insurance (anything worth $50 or more). These additional fees are hard to determine so if you have any questions, please call us at 800-239-4188 or click here to EMAIL US. If an order is sent without sufficient shipping costs, then a "due balance" bill will be sent and it must be paid before the order can be shipped. Thank You.