The Ultimate Record Label
Mail Order / Fax Order Form
Use this order form to mail or fax your order in to us
Platinum Millennium Publishing  P.O. Box 1733
BRIDGEPORT, CT 06601-1733 U.S.A.
• Phone: Toll Free 1-866-Play-Your-Music or 1-866-752-9968
FAX: 1-203-286-1761

To: Client Services for Immediate Processing

From:

 

 

FAX NUMBER: (203)-286-1761

Date:

 

 

Please rush me:

The Sell Music Online Like Crazy Course + the Free Bonuses
for just $197- plus $13- shipping for a total of $210-
 


Check additional options, if desired:

Include The Industry Yellow Pages Music Industry Contact Directory for an additional $59-

Include The 101 Music Business Contracts Software for an additional $77- I have a PC  Macintosh Computer

 

First Name: _________________ Last Name: ________________

Company Name: ________________________________________

Phone Number: ________________________________________

E-Mail Address: _______________________________________

 

Shipping Address: ______________________________________
Shipping Address: ______________________________________

City: _________________________________________________

State / Province: ________________________________________

Zip / Postal Code: _______________________________________

Country: ______________________________________________

 

Please Circle Payment Type:

Check - Money Order - Visa - Master Card - Discover - American Express

Credit Card Number: _____________________________________

Expiration Date: _________________________________________

CCV or Security code:_________________

Last 3 digits on the back of the card – or last 4 on the front of an AMEX card.

 

Your Signature: _________________________________________

  

Shipping:

$13 U.S. & canada

$25 International
 

All Orders must be faxed to: 1-203-286-1761
or Mailed to: 

Platinum Millennium publishing  p.o. box 1733 BRIDGEPORT, Connecticut U.S.A. 06601-1733
•Phone: Toll Free 1-866-Play-Your-Music or 1-866-752-9968 •  FAX: 1-203-286-1761
 

Referral Code:     1290