Dreamsongs
Order Form
If youÕd like to purchase
the stereo CD version of ÒDreamsongs,Ó hereÕs how. Save this html form as a PDF
document and print it out. Fill it out and send it, along with your check or
money order (US funds only) to:
Dreamsongs
Modiolus
Opera & Die Studio
P.O.
Box 99716
Name:_______________________________________________________________
Address:_____________________________________________________________
City:_________________________________
Email (optional): _____________________
State:________________________________ Postal
(Zip) Code:________________
Quantity
of CDs:_____________ Purchase
price: $6.00 US ea. (shipping
included)
Total
amount enclosed (quantity x 6):____________ (make check payable to Modiolus Opera & Die)
Your
CDs will be shipped promptly via the US Post Office. This service is not as much
about selling records as it is helping people, so weÕre trying to keep
production costs as low as possible. All CDs have full color labels printed
directly on the disc, and come in white windowed sleeves with flaps, shipped in
protective CD mailers. And remember, one dollar of each CD sale is donated to head injury research.
If you could, also please take a moment and fill out the questionnaire below.
Your feedback is greatly appreciated.
Age:_______ Gender:________ Are you a recovering head injury patient? yes___ no___
Music
preferences (check all that apply): rock____ country____ hip hop/rap____
classical____
jazz____ folk/bluegrass____
blues____ new age____ alternative rock____ acoustic____ other____
Reason
for purchase:
__ I lost the CD that came with the book
and would like to buy another one
__ I heard the samples on the website and
IÕm curious about the music
__ I downloaded the mono MP3 versions and
would like to hear them in stereo
__ I know someone who is a recovering head
injury patient and would like them to have a copy
of Dreamsongs
__ I would like to contribute to a good
cause
__ None of the above __ All of the above
Thank you for your
support.