North Country Radio - Mail Order Form

USA and CANADA orders only

Other Nations please use online secure order form

Name: Shipping Address:
City or Town: State or Province:
Zip or Postal Code: Country:
Telephone: Fax:
Email:

Method Of Payment (Check One):

Visa Check Money Order Other
MasterCard
If Credit Card (MC/Visa)CC Number: Exp Date:

Security Digits (Located on back of credit card, 3 digit number, to right of signature)

 

Orders will be shipped on receipt of payment

ITEMS ORDERED

QTY PRODUCT DESCRIPTION PRICE EA. ($USD) TOTAL ($USD)
   
$
$
   
$
$
   
$
$
   
$
$
Subtotal
$
NY State Residence add 8.25% sales tax
$

Postage and handling (USA orders only)

$10.00 First Item + $1.00 Each Add'l Item

$

Postage & Handling (CANADA)

$15.50 First item+ $4.50 Each Add'l Item

$
Total Amount
$

Send this completed form with payment to:

North Country Radio

PO Box 200

Hartford, NY USA 12838-0200

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NORTH COUNTRY RADIO

PO Box 200, Hartford NY 12838-0200

EMAIL: support@northcountryradio.com Tel 518-854-9280 Internet http://www.northcountryradio.com