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Action Piano Company
Mail-In Order Form
Box #91
Lansford, Pennsylvania 18232-0091

********To order any of our ON SALE TODAY items you can print out this form, or simply PRINT your selections on any plain paper, complete with your name and full mailing address. Enclose your check for the full amount. There is NO ADDITIONAL shipping and handling charges to add... DO YOU BELIEVE THAT ONE-- No extra charges at all * . Using regular old snail-mail for this order will only add a day or two to your delivery time, and we ship everything on sale directly from our own stock. Our sale prices are the lowest you will find, and these are top quality products, fully guaranteed and we know you will be happy. So go ahead and mail your order out. The postal service will thank you, and we do too.

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Name_________________________________________________________________

Mailing Address ________________________________________________________

City, State, Zip __________________________________________________________

Items Ordered... PLEASE PRINT

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* For piano and key polish only, please add $1.00 per item for First Class Shipping ____________________

* For less than 3 piano rolls, please add $2.50 per roll for First Class Shipping _________________________________

TOTAL OF YOUR ORDER ___________________________________________________

QUANTITY

DESCRIPTION OF ITEM

AMOUNT

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SIMPLY HIGHLIGHT AND PRINT THE ORDER PORTION OF THIS PAGE. FILL IN THE QUANTITY, DESCRIPTION OF YOUR ITEMS AND THE PRICE SHOWN. ENCLOSE YOUR CHECK FOR THE TOTAL AMOUNT AND MAIL TO THE ADDRESS AT THE TOP OF THE PAGE. PLEASE ALLOW TWO WEEKS FOR YOUR ORDER TO BE PROCESSED AND ARRIVE AT YOUR DOOR. THERE ARE NO ADDITIONAL SHIPPING CHARGES. INCLUDE YOUR E-MAIL ADDRESS AND YOU WILL RECEIVE A CONFIRMATION OF YOUR ORDER WITHIN 24 HOURS. IF, FOR ANY REASON, YOUR ORDER CAN'T BE FILLED YOUR CHECK WILL BE RETURNED UNCASHED.

Your E-Mail Address __________________________________________________________________

FIND US ANYTIME ON THE WEB at www.pianosrebuilt.com

ALSO - USE THIS FORM FOR SWIVEL STOOLS, PIANO CHAIRS, AND PIANO COVERS.

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