Jimmy K Polkas ORDER FORM

Jimmy K Polkas On-Line Order Form

NOTE - IF YOU HAVE ANY PROBLEM ORDERING, PLEASE CALL US (440) 846-0404 / 1-866-454-6695
or e-mail customerservice@jimmykpolkas.com

Click "Submit" below to send your order. No credit card information is needed (we'll invoice you).

You must fill in the information below completely.
OHIO RESIDENTS - 8.00% OHIO STATE SALES TAX IS ADDED TO YOUR ORDER
We are licensed in Ohio & must collect State & County Sales Tax on purchases shipped within the State of Ohio

*Click Here For Shipping Details

Desired shipping method: How Did you hear about us?

       Your name Street Address:
                 City: State:     Zip Code:

        Area Code     Telephone No. E-Mail Address

Qty Format Artist(s) Title(s) Price (per item)

Artist: Title: Price:

If you wish to order more than 10 items, fill out and submit a separate order form

Add comments, special instructions, etc. HERE

You must click SUBMIT to send your order!
Be patient - it may take a moment or two to process.........

Reset will CLEAR your information - Click this only if you want to completely start over!