Please fill out the form and either
fax it to: +49-6131-508716 OR
Email it to: jazzinimainz@web.de OR
snail-mail it to:
Dr. Jörg Heuser
Georg-Büchner-Str. 15
D-55129 Mainz
Germany
=========================================

I YOUR ADDRESS

Your name: ______________________________

Your Email: ______________________________

Street, No.: ______________________________

Zip(PLZ)/City: ______________________________

State/Country: ______________________________

Phone: ______________________________

Fax: ______________________________

II METHOD OF PAYMENT
Please select the method of payment:
_____ BANK TRANSFER (Banküberweisung)
_____ US POSTAL money order (Postanweisung)
_____ WESTERN UNION TRANSFER (Geldanweisung)
_____ PAYPAL (www.paypal.com) (send to => jazzinimainz@web.de)
_____ (Credit Card) TRANSFER via www.moneybookers.com
_____ CASH (in a secure envelope)

III Your order [please check the box(es)]:

_____ COMPLETE SET (5CDs 1 DVD) [Euro 75/$80]
      How many _____

_____ ZAPPA PLAYS FOR BACH [Euro 12/$14] plus shipping
      How many _____

_____ UNVERSCHÄMTHEIT Vol. II [Euro 15/$17] plus shipping
      How many _____

_____ DVD OUCH PATROL feat. Napoleon Murphy Brock [Euro 18/$21] plus shipping
      How many _____

_____ CD OUCH PATROL feat. Napoleon Murphy Brock [Euro 15/$18] plus shipping
      How many _____

_____ UNVERSCHÄMTHEIT Vol. I [Euro 13/$16] plus shipping
      How many _____


_____ Insanity Sauce [Euro 12,50/$15] plus shipping
      How many _____

IV POSTAGE/SHIPPING:
for up to 2 items:
(within Germany: Euro 2,20 ; Europe: Euro 4 ; outside Europe: Euro 6)
3 & more items:
(within Germany: Euro 4,10 ; Europe: Euro 6 ; outside Europe: Euro 12)