Wild Willie's Keyboard Clinic Order Page

If you prefer to register for one of the clinics electronically and pay by credit card just Press Here!

If you want the main order form Press Here!

To order by mail just print this page on your printer and mail with payment to Wild Willie's Keys To The Kingdom.

Keyboard Clinic Order Form (registration fees non-refundable)
Keyboard Clinic held at	Number of Persons	Ea. Price	Total Price
tba		$35.00
tba	10	$25.00	$250.00
tba		$35.00
tba	10	$25.00	$250.00
GRAND TOTAL

All funds in US Dollars.

PLEASE PRINT CLEARLY

__________________________________ _____________________________________

First Name Last Name

__________________________________________________________________________
Shipping Address (can not ship to P.O. Box)

_________________________ __________ ___________ ( ____ )______________

City State Zip Daytime Phone

Email Address ___________________________

Payment Method:

___Visa ___Mastercard ___American Express ___Discover ___check (check # ______)

Credit card customers: shipping address must match credit card billing address & customer name must match name on credit card.

Credit Card Number _________________________________ Expiration Date___________

Signature__________________________________________________________________

IF registering for group rate list additional names and phone numbers here:

First Name Last Name Address City St Zip Phone

Please return this form completed to:

Wild Willie's Keys To The Kingdom
PO Box 54138 Tulsa, OK 74155-0138

or call toll free 877-778-KEYS

__________________________________	_____________________________________
First Name	Last Name

_________________________	__________	___________	( ____ )______________
City	State	Zip	Daytime Phone