Name
Address
Address
City, State, Zip
Phone 1 Phone 2
E-mail address

Number of LP albums sent for transfer package: A B C

Number of tapes being sent: Reels Cassettes 8-tracks

Number of 78's being sent: Standard 78's Home Disc Recordings

Number of wire recordings being sent:

Other media not listed above:

Additional copies of CD's requested:

Please note on the back of this page, or on a separate sheet, any special instructions you'd like us to follow, what text you would like to have printed on the CD's, and so on. If you're sending collections of discs or tapes, and want them in any particular order, please NUMBER the records with sticky notes. And if there are names, dates, etc. that you would like to appear on the CD's, please send us that information in an e-mail, to avoid errors.

Check box if this a rush order