| NAME | |
| SHIPPING ADDRESS | |
| CITY | |
| STATE | |
| ZIP | |
| COUNTRY | |
| PHONE | |
| FAX | |
CHECK |
|
MONEY ORDER (For Fast
Delivery) |
| DESCRIPTION | OPENING | PRICE EACH | QUANTITY | TOTAL |
| SUB-TOTAL | |
| FLORIDA RESIDENTS ADD 7% SALES TAX | |
| SHIPPING & HANDLING: ADD - USA US$5, OVERSEAS US$12 | |
| TOTAL |
SEE YOUR LOCAL
MUSIC DEALER OR ORDER DIRECTLY WITH THIS FORM. |
PRINT THIS FORM
AND MAIL IT WITH CHECK OR MONEY ORDER TO: BOBBY DUKOFF MOUTHPIECES |
IF ORDERING DIRECT: THERE IS
A ONE TIME EXCHANGE OR MONEY BACK GUARANTEE (IF RETURNED UNDAMAGED AND
WITHIN 10 DAYS). PLEASE SEND ANY COMMENTS OR QUESTIONS TO BOBBY DUKOFF AT dukoff@bellsouth.net. |