UNITED STATES.
ORDER FORM.
Please Print out this form and Fill in the following information:
SURNAME:_________________________________________________________
FIRSTNAME:________________________________________________________
INITIALS:___________________________________________________________
ADDRESS:
STREET:____________________________________________________________
_____________________________________________________________________
STATE/PROVINCE:_________________________________________________________
ZIP
CODE:_________________________________________________________
COUNTRY:__________________________________________________________
OTHER
INFO:___________________________________________________________
The following 2 lines are OPTIONAL!
DAYTIME PHONE NUMBER(including diling and Country 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