Showcase Order Form


This is a secure and private transaction. Fields marked with an (*) are required.

Person placing the order
Name *
first middle last
Telephone number *
(this will never be used for telemarketing)
E-mail address *
Duration
Desired start date *
year mo day  
calendar
Duration of program *
Artist information
Artist/band name *
Musician ID
What is this?
CD/Album information
Album title *
Album description
Album cover location (URL)
Upload it here
MP3 page location
Upload a track here
Record company name
Retail store links
List up to three


Review links
List up to three


Payment information. Leave blank if you plan to pay by check or PayPal.
Credit card number
Credit card expiration date
mo year
Name on credit card
Full billing address (include city, state and zip code)

We accept the following credit cards: Visa, Mastercard, American Express and Discover.

Outside the United States? Please leave the credit card information blank and pay via PayPal. Send to mricci@visionx.com.


For your safety and peace of mind, your credit card number will be deleted from our online database as soon as your order is processed.