demo orderform

Please print out this form,
fill it out with a black pen & mail or fax with credit card information to us.
Mail money order and form to: Midi Mark Sales, PO Box 217, Whittier, CA 90608, U.S.A.
or Fax it to: 562-698-7188 - Back to home page

NAME __________________________________________ COMPANY NAME (optional)

EMAIL ADDRESS _______________________________ - ________________________

ADDRESS ____________________________________ APT _______

CITY _______________________ STATE _____ ZIP _____________

PHONE ( _____ ) ___________________ FAX ( _____ ) ____________________

SAMPLER MAKE ___________ MODEL _____________

DEMO DISK ORDER FORM ($6 per disk, shipping included)

___ EPS, EPS16+, ASR, TS, K2000 DEMO DISK. (disk comes in 16+ format, ds/dd)

___ MPC-60, MPC-60ii, MPC-60 v.3 (disk comes in mpc-60 format, ds/dd)

___ MPC-2000, MPC-3000 (disk comes in mpc-3000 format, ds/hd)

___ S-1000, S-2000, S-3000, S-5000, S-6000 (disk comes in S-1000 format, ds/hd)

___ Roland S-50 demo disk (disk comes in s-330 format)
compatible with S-50, W-30, DJ-70, S-330, S-550, S-760 specify which unit you own.

SUB TOTAL------------------------------------------ $ _________
CALIFORNIA RESIDENTS ADD 8.25% TAX .$ _________
SHIPPING & HANDLING INCLUDED . $ ___0______
FOREIGN ORDERS ADD $10.00 SHIPPING . $ _________

TOTAL ----------------------------------------------$ _________

IF YOU WOULD LIKE TO PAY BY MONEY ORDER, MAIL THIS FORM AND MONEY ORDER TO US.

PAY BY CREDIT CARD x ONE ___ AMEX .... ____ VISA .... ____ MASTERCARD .... ____ DISCOVER

NAME ON CARD ______________________ SIGNATURE _______________________________

CARD NUMBER __________________________________ EXP DATE _________