Player-Care Secure Order Form
For the Best-Selling QRS Rolls

ATTENTION: DO NOT HIT THE "ENTER" KEY WHEN FILLING IN THIS FORM. IF YOU DO, YOU WILL HAVE TO START OVER AGAIN. TO MOVE FROM SPACE TO SPACE, USE THE "TAB" KEY, "ARROW" KEYS, OR THE "MOUSE" (CURSOR).

Problem Placing an Order -- Call 1-800-870-8784 (for orders only)

Secure Credit Card Orders Only

All transactions will be transferred via our Secure Server.

Use this Order Form if you're paying by Credit Card.
Discover, Visa or Master Card ONLY! ... NOT American Express!!
An email will be sent to confirm receipt of your order within 24 hours.
Non-Roll Order-Related Questions -- Click Here!

You will be notified by Email for an Order Verification within 24 Hours!
You must Reply to that Email to continue the Ordering Process.
Don't forget, there is an $110.00 Minimum Purchase Requirement!
What Less than $110.00 worth? -- Click Here!

---

Provide all of the following information.

Billing/Mailing Address (Where your credit card bill is sent.) IMPORTANT NOTE: If your Billing/Mailing Address DOES NOT MATCH the information on file with your credit card company and the charge is APPROVED, you WILL BE CHARGED an additional $1.75 for Credit Card Fraud Insurance. This is the charge that the credit card company now charges me when the information YOU submit does not match the information in their files. If the items you order are being send to an address other than your credit card billing address, put that information in the SHIPPING Address near the end of this page.
.... Full Name
.... Valid Email Address
.... Email Address (again)
.... Billing/Mailing Address
.... City or Town
.... State or Province
.... Zip Code ... .... (Zip) +4 (if known)
.... Country
.... (Home**) Phone Number
.... FAX Number (not required)

Best-Selling QRS Rolls
Titles in BLUE are $14.00
Titles in RED are $21.00
Click on Checkbox to Select Roll
... Chicago Medley Part 1 - XP191-B
... Patsy Cline Medley - XP243-B
... Piano Man - 10785
... The Sound Of Music - XP129-B
... Amazing Grace - 10481
... The Entertainer (Scott Joplin) - 10518
... My Heart Will Go On (Titanic theme) - 11027
... The Wizard Of Oz - XP217-C
... Wind Beneath My Wings - 10922
... Chicago Medley Part 2 - XP192-B
... Happy Birthday Medley (5 songs) - 8312
... Great Balls Of Fire - 10285
... The Phantom Of The Opera Part 1 - XP263-B
... Frank Sinatra Medley - XP226-C
... Imagine (John Lennon) - 11043
... Gershwin Medley (Liberace) - CEL121-B
... The Lion King Part 1 - XP375-C
... Candle In The Wind (Princess Diana) - 11025
... Billy Joel Hits - XP237-B
... Grease Medley - XP270-C
... Elton John Hits Vol 3 - XP299-C
... How Great Thou Art - 9707
... Abba Hits - XP406-C
... Beatles Hits Vol 1 - XP231-B
... Music Box Dancer - 10642
... John Denver Hits - XP189-C
... Glenn Miller Hits - XP195-C
... O Brother Where Art Thou Part 1 - XP510-C
... Boogie Woogie Piano Vol 1 - XP279-C
... The Lion King Part 2 - XP390-C
... The Old Piano Roll Blues - Q184
... Pachelbel's Canon in D - 10840
... Righteous Brothers Hits - XP368-C
... Garth Brooks Hits - XP337-C
... O Brother Where Art Thou Part 2 - XP511-C
... Maple Leaf Rag (Scott Joplin) - 9725
... Fur Elise (Beethoven) - 10872
... Neil Diamond Hits - XP239-C
... Elton John Hits Vol 2 - XP298-C
... Danny Boy (Londonderry Air) - 2458
... Brown-Eyed Girl - 11040
... Salute To The Armed Forces - XP319-B
... Fiddler On The Roof - XP122-B
... Disney Classics - XP235-B
... Boogie Woogie Bugle Boy - 10505
... Elvis Presley Hits Vol 1 - XP179-B
... The Chicken Dance (Bird Dance} - 10858-A
... You Are My Sunshine - 7258
... God Bless The USA - 10932
... Simon & Garfunkel Hits, played by Ferrante & Teicher - CEL193-B
... Beach Boys Hits Vol 2 - XP351-B
... Bohemian Rhapsody - 10972
... Polka Medley - XP229-B
... Beer Barrel Polka - 7009
... Macarena - 11018
... Sgt. Pepper's Lonely Hearts Club Band Part 1 - XP502-C
... My Fair Lady - XP124-B
... The Phantom Of The Opera Part 2 - XP310-B
... The Halloween Roll - XP467-B
... American Pie - 10468-A
... Hank Williams Hits - XP211-B
... Beauty And The Beast - XP335-B
... The Eagles Hits - XP468-C
... Oklahoma Medley - XP121-B
... Bridge Over Troubled Water - 10390
... Elvis Presley Hits Vol 3 - XP209-B
... You've Got A Friend In Me - 11046
... Happy Birthday To You (8 choruses) - 80006
... The Music Man - XP134-B
... Fats Domino Hits - XP405-C
... Beatles Hits Vol 4 - XP353-B
... Mack The Knife - 9704
... Duelling Banjos - 10497
... Five Foot Two, Eyes Of Blue - Q201
... When Irish Eyes Are Smiling - Q182
... Memory (from Cats) - 10787
... Let Me Call You Sweetheart - Q116
... Only Time (Enya) - 11053
... Sleepless In Seattle - XP425-C
... Beethoven's Fifth (1st Movement) - XP457-C
... Barry Manilow Hits Vol 1 - XP187-C
... Just A Closer Walk With Thee - 8936
... Hotel California - 10592
... Sweet Home Alabama - 11055
... Beatles Hits Vol 2 - XP260-C
... Irish Song Medley - XP292-C
... Civil War Music - XP320-C
... Sgt. Pepper's Lonely Hearts Club Band Part 2 - XP503-C
... Theme from Cheers - 10911
... Annie Part 1 - XP180-B
... Mary Poppins Part 2 - XP363-C
... The Old Rugged Cross - 1552
... The Nutcracker Suite Part 2 - C126-B
... Hymns For The Home - XP316-B

Shipping Address (if different from above)
... Name
... Address
... City
... State
... Country
... Zip Code

... Credit Card Information
... Card Holders Name
... Credit Card Number
... Expiration Date

Shipping Options (Select AT LEAST ONE Option):

USPS Media Mail

USPS Parcel Post

USPS Parcel Post (AirMail)

USPS Priority

USPS Priority Mail International (for non-US Orders)

USPS Delivery Confirmation ($0.55)

USPS Insurance

UPS (United Parcel Service)

Goods sent via USPS Media Mail, Parcel Post, or Airmail cannot be tracked or traced unless you also select Delivery Confirmation. Also, we will not accept liability for goods sent via USPS Media Mail, Parcel Post, or Airmail unless you select the Delivery Confirmation or Insurance options.

---

Enter Other Titles & Roll Numbers

Please Select or

Your HOME PHONE NUMBER is requested because it might be necessary to contact you for a number of reasons during non-business hours. Failure to provide a home number could result in your order being delayed. Please comply with this simple request. Provide a number where you or a family member can be reached. Thank you...

Don't forget, there is an $110.00 Minimum Purchase Requirement!

---

You will be notified by Email within 24 Hours!
You must Reply to that Email for the Ordering Process to continue.

---

Print this page

---

As per the Fair Credit Billing Act, your bank cannot hold you liable for more than $50.00 of fraudulent credit card charges. PLAYER-CARE will pay the $50.00 if the unauthorized use of your card resulted from a purchase made through our site. We are so confident of the security measures we've put in place, we'll also pay you an additional $25 just for the inconvenience!

---

© 1996-2006 Player-Care.com Privacy Policy