ORDER FORM

Step 1: Please fill in the form fields below.

Step 2: Print this form to send with your payment.

Step 3: Submit this form electronically to put your order in process.

Step 4: Make your check or money order payable to Daffodil Music and send with this form to:

Sally Heckelman
11505 Daffodil Lane
Silver Spring, MD 20902


Name* Email Address*

Street Address*

City* State* Zip*

Phone*

Name of Child's School Teacher



CD: Put a Smile on Your Face QTY  @ $15 each= 
CD: Tap Your Feet to a Jewish Beat QTY  @ $15 each= 
Cassette: Tap Your Feet to a Jewish Beat QTY  @ $10 each= 
CD Special: Put a Smile on Your Face
& Tap Your Feet to a Jewish Beat
QTY  @ $25 per set= 
Orders of 10 or more receive a 10% discount Less Discount 
Maryland Residents Please Add State Sales Tax of 5% MD Sales Tax 5% 
Please Add Shipping & Handling:  $2.00 for one, $3.25 for 2-4 Plus S&H 
TOTAL ITEMS  TOTAL AMOUNT 



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