To order B&H Media Player please complete the following form and mail it to:

     B&H Industries
     94 Morton Rd.
     Falmouth, VA 22405


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                              Please Print

      Name: ______________________________________________________

   Company: ______________________________________________________

   Address: ______________________________________________________

            ______________________________________________________

      City: _________________________ State: _____ Zip: __________
 

1. Indicate number of units below:

        ___ copies of B&H Media Player     X   $19.95         $__________
     
            (VA Residents Please add 4.5% sales Tax.)         $__________
              
 
                                                    Total:    $__________


        U.S. orders only. Make Check or Money Order Payable to:
                             B&H INDUSTRIES