Dreamsongs Order Form

 

If you’d like to purchase the stereo CD version of “Dreamsongs,” here’s 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

Pgh., PA 15233

 

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 we’re 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 I’m 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.