UNITED KINGDOM.

ORDER FORM.


Please Print out this form and Fill in the following information:

SURNAME:_________________________________________________________
FIRSTNAME:________________________________________________________
INITIALS:___________________________________________________________

ADDRESS:
STREET:____________________________________________________________
_____________________________________________________________________
CITY/TOWN:_________________________________________________________
COUNTY:____________________________________________________________
POST CODE:_________________________________________________________
COUNTRY:__________________________________________________________

The following 2 lines are OPTIONAL!
DAYTIME PHONE NUMBER
(including diling code):_______________________________________
EVENING PHONE NUMBER
(including diling code):_______________________________________

Please Select your choice of CD: Please tick the box.

CD 1 4 HOURS IN GEORGIA: .. ..............
CD 2 Radio Interview ..............
CD 3 Comming Soon..(pre-order) ..............
  Other...(please state) ..............

Please write your choice here:______________________________________Number Required:____________
Please write your second choice here:________________________________Number Required:____________
Please write your third choice here:__________________________________Number Required:____________

Payment Methods:

British Pounds . £10 .
Cheques . £10 . or $17 .
US Dollas . $17 .

We suggest you use a Registered Postal Service.

Please write your payment method here:___________________________________________________

Total Cost:In correct currency:_____________________________________________

Signed:________________________________


Please send Your Order to:

PETE JOHNSON.
CUSTOM AMPLIFICATION.
80 EDLESTON ROAD,
CREWE,
CHESHIRE,

ENGLAND.

Tel. 44 (01270) 214779