Independent Records
Product Registration Form
(Please Print)

Contact Name                                                                                                                                                                      
Street
Address
                                                                                                                                                                     
                                                                                                                                                                     
Address                                                                                                                                                                      

City

                                                                                     State                         Zip                                          
Phone                                                                                      Fax                                                                          

Artist/
Band
Name


                                                                                                                                                                     
Product
Type
(Circle one)
 CD                         Cassette                      VHS                     7-inch                    Vinyl
           DVD                     Other                       
Album/
Product
Title


                                                                                                                                                                     
Shipping
Type
(Circle one)
 E-mail                                Standard Shipping
E-mail
Address

                                                                                                                                                                     


NOTES

Each bar code number and logo graphic is unique to each album title. A different number needs to be assigned to each title even if the band or artist stays the same. CD and cassette releases of the same album also have different numbers from each other. The cost is $20 for each single format release. If releasing both CD and cassette of the same title, the price is $35 for the two format combinations. For three or more format combinations the price is $50. Bar codes sent using standard shipping are supplied on diskette. Registration with self-stick labels are available for $60/$110 depending on number of formats needed.

Single Format Label Registration $20.00
Two Format Label Registration $35.00
Three Plus Format Registration $50.00
Single Format Registration w/ Self-stick Labels (shipping already included in price) $60.00
Two Format Registration w/ Self-stick Labels (shipping already included in price) $110.00
Standard Shipping* $8.00

*If emailed there is no shipping

Make check or money order payable to Independent Records and send it to the following address:

U.S. Post Office
Independent Records
P.O. Box 510
Blairstown, NJ 07825
Federal Express/UPS
Independent Records
2 West Crisman Rd.
Columbia, NJ 07832