DPH's Music & Arts International
 ORDER INFORMATION
                   
To order: Please see the price and S/H charge below.

Payment methods: check, money order, or credit cards, including VISA,   MASTERCARD and DISCOVER.

Order by phone/email, or have questions, contact:
Phone: (240) 418-5038 (English or Chinese). Emails: sales@dphmusic.com,   or doctorhu@dphmusic.com


Office hours for phone order: 8:00 a.m. - midnight EST, 7days/week

Order by fax: Fill out the Order Form and Credit Card Authorization Form   below, and send the fax to Sales at DPH, (703) 996-4686.

Order by mail:
  1. Fill out the Order Form. Complete the Credit Card Authorization Form, or if pay by check or money order, make the check or money order payable to DPH's Music & Arts International, LLC
  2. Mail to:  
    DPH's MUSIC & ARTS INTERNATIONAL, LLC
    12704 FLAGSHIP CT.
    HERNDON, VA 20170


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Order Form         
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   Quantity                  Item (Circle)            Color (Circle)  Availability     Unit Price                    Amount
_____________________________________________________________________________________
    
   (        )     PE-2 Piano Pedal Extender          Black          in stock             $248.00              $
   
   (        )     PE-2 Piano Pedal Extender       Mahogany     in stock             $248.00              $

   (        )     H.A. Piano Bench Cushion                                   in stock            $45.00                 $
                  Cushion color options:  Golden, Black, Blue, Rose, Purple and Red   
  ______________________________________________________________________________________
                                                                                                    
                                                                                                                         Sub Total   $_________
     Charges for Shipping & Handling (in continent USA)
     PE-2 Piano Pedal Extender:    $20.00/unit
     H.A. Piano Bench Cushion:     $6.00/unit                                                                       $_________

                                                                                                         Total Amount Due   $__________
_______________________________________________________________________________________
   Ship the above order to (please print):
_______________________________
   Name
______________________________________________________________________________________
  Address
______________________________________________________________________________________
  City, State, Zip
______________________________________________________________________________________
   Phone (s)
______________________________________________________________________________________
   Fax
______________________________________________________________________________________
   Email
______________________________________________________________________________________        
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 PAYMENT BY CREDIT CARD AUTHORIZATION FORM
 Check one:
               (        ) VISA          (        ) MASTERCARD          (        ) DISCOVER

 CREDIT CARD NUMBER: _______________________________________________________

 EXP. DATE: _________________  SECURITY CODE (last three digits on back of the card) _____________

 AUTHORIZED SIGNATURE ____________________________   

 CARDMEMBER'S NAME ______________________________