Jimmy K Polkas ORDER FORM

Jimmy K Polkas On-Line Order Form

Click "Submit" below to send your order. No credit card information is needed (we'll invoice you).

You must fill in the information below completely.
OHIO RESIDENTS - 7.75% OHIO STATE SALES TAX IS ADDED TO YOUR ORDER
We are licensed in Ohio & music collect Sales Tax on purchases shipped within the State of Ohio.

*Click Here For Shipping Details

Desired shipping method: How Did you hear about us?

       Your name Street Address:
                 City: State:     Zip Code:

        Area Code     Telephone No. E-Mail Address

Qty Format Artist(s) Title(s) Price (per item)

Artist: Title: Price:

If you wish to order more than 10 items, fill out and submit a separate order form

Add comments, special instructions, etc. HERE

You must click SUBMIT to send your order!
Be patient - it may take a moment or two to process.........

NOTE: YOU MAY RECEIVE A "WARNING" FROM YOUR VIRUS PROTECTION SOFTWARE - IT IS COMPLETELY SAFE TO SUBMIT THIS ORDER FORM.
IT IS PROCESSED THROUGH "FORMBUDDY.COM" WHICH IS NOT OUR SITE, SO SOME PROGRAMS WARN YOU BECAUSE YOU'RE BEING "REDIRECTED".
ANY QUESTIONS OR IF YOU WANT TO PHONE IN YOUR ORDER, CALL 440-846-0404 OR 1-866-454-6695 - IF WE'RE OUT OF THE OFFICE, LEAVE A MESSAGE & WE'LL CALL YOU!

Reset will CLEAR your information - Click this only if you want to completely start over!