HOW TO ORDER MR. ROTMAN'S RECORDINGS
AND VIDEO
- 1. Print this form
2. Complete this form by specifying product you want,
- format you want (CD, Cassette, Video NTSC,
Video PAL or
Video DVD),
- and fill in your name, address and method
of payment.
3. Please make checks or money orders payable to: SAM
ROTMAN
- 4. Mail this form and your payment to:
- SAM
ROTMAN
- 462 N. Calle Largo
- Mesa,
AZ 85207-6651
USA
-
- CDs, cassettes and videos ordered from
this website will be
personally autographed for you by Mr. Rotman.
Please allow 2 to 3 weeks for delivery.

RECORDINGS
PORTRAIT OF A
PIANO
QTY: ____ CD @
$15.00
ITEM TOTAL $__________
QTY: ____ CASSETTE @
$10.00 ITEM TOTAL $__________

IMPRESSIONS ~ Piano Portraits of Claude Debussy
QTY: ____ CD @ $15.00
ITEM TOTAL $__________
QTY: ____ CASSETTE @ $10.00 ITEM TOTAL
$__________

- MUSSORGSKY
- PICTURES AT AN EXHIBITION
RACHMANINOFF PIANO WORKS
QTY: ____ CD @ $15.00
ITEM
TOTAL $__________
QTY: ____ CASSETTE @ $10.00 ITEM TOTAL $__________

-
BEETHOVEN
-
-
QTY: ____ CD @ $15.00
ITEM
TOTAL $__________
QTY: ____ CASSETTE @ $10.00 ITEM TOTAL $__________

VIDEO
SAM ROTMAN,
Concert Pianist
The Music and Testimony of a Jew for Jesus ~
QTY: ____ VIDEO @ $15.00 ITEM TOTAL $__________
Specify format: (check one)
NTSC r
PAL r
DVD r

-
- A
DRAMATIZATION OF
THE LIFE OF SAM ROTMAN
.
QTY: ___ CD @ $10.00 each
ITEM
TOTAL $__________
QTY: ___ CASSETTE @ $5.00 each ITEM TOTAL $__________
SUB-TOTAL OF ALL ITEMS $__________
Shipping & Handling Charge @ $2.00 per Item: $__________
Total Payment Enclosed: $__________
I have enclosed my check r money order
r
NAME ____________________________________________
ADDRESS _________________________________________
APT # or SUITE ________ City
_______________________
State _______ ZipCode _________ Country _____________
Phone (_____) ______-___________