Coupon Book Order Form - Brainerd Music Department

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Coupon Book Order Form

Fill out the form below to have a BHS music student hand deliver a coupon book to your home or business.
PLEASE HAVE PAYMENT READY - $25 - checks made out to Brainerd HS Music

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Address *

How many books? *

When would you like a student to deliver the book? *

Monday Sept 28, 4-6pm Monday Sept 28, 6-8pm Tuesday Sept 29, 4-6pm Tuesday Sept 29, 6-8pm Wednesday Sept 30, 4-6pm Wednesday Sept 30, 6-8pm Thursday Oct. 1, 4-6pm Thursday Oct. 1, 6-8pm Friday Oct. 2, 4-6pm Friday Oct. 2, 6-8pm I will pick up my book from the BHS Main Office

Special Instructions *

Beware of the Dog...etc..

Name of music student (if applicable) *

Use this box to designate delivery by a student you know. If left blank, a student will be assigned.

Submit

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Brainerd High School
702 South 5th Street
Brainerd, MN 56401
218-454-6200

Forestview Middle School
12149 Knollwood Drive
Baxter, MN 56245
218-454-6000

Brainerd Music Department | 218.454.6253 | 702 South 5th Street, Brainerd MN 56401