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To pay for your membership by mail, please do the following:
Please fill in the fields below.
Then print this form and send it by mail to the address above.
The Tuxedo Club
Credit Card by Mail Form
Post Mail to: Stephen L. Gilbreath, The TUXEDO CLUB, 1428 Virginia Road, Hueytown, AL 35023-8417
205-491-7867 or 205-492-6879 E-mail: SLG@BigBandsAlive.com
For payment of -- please choose one of the Charter Membership Options below:
From: Name and Address
(Your Full Name & Address exactly as it appears on your credit card account statement. If shipping address is different please also show address where we should ship your Club card, receipt, Club news reports and your Big Band Live Show CDs.)
Optional Message: (Use this space if you want the Club to ship bonus gift CDs directly to your friends at our expense, please provide the names and shipping addresses in the space below -- for lifetime bonus gift CDs -- up to 7 CDs. A gift card in your name will be enclosed with each. Leave blank if you do not want to send gift CDs -- or use this space for any optional message.)
Order Date:
Signature:
Card Number:
The Tuxedo Club Monthly Newsletter will be e-mailed to if you provide your e-mail address:
Your e-mail address is strictly private with the Club and is not shared with others.
Expiration Date:
Your telephone number:
