** Custom Didgeridoo's Product Order Form **

Please fill this out and send it to:
Dennis Plucinik II
7485 State Fair Blvd.
Baldwinsville, NY
13027

I will confirm the reciept of your payment and also confirm the date that your didge is shipped.
Note: Orders of 4 or more will recieve a discount of 50% off the subtotal, and companies will recieve free website advertising. 

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*Personal Info:*


Last Name ____________________________ First Name ______________________ M.I. ___________

*Shipping Info: *


Shipping Address _______________________________________ City ___________________________


State ___________ Zip Code _________________-___________ Phone Number ___________________


Description of Didge: ___________________________________________________________________

					Price __________ Qty ________ Total _____________ 


Description of Didge: ___________________________________________________________________

					Price __________ Qty ________ Total _____________


Description of Didge: ___________________________________________________________________

					Price __________ Qty ________ Total _____________


Description of Didge: ___________________________________________________________________

					Price __________ Qty ________ Total _____________


								Subtotal: _______________							
                                     (NY residents pay 7% sales tax) Tax: _______________

                                	 (Shipping Methods: Priority mail 
					 (inside the U.S.) 6$ per item. 
                                         This includes complete insurance
                                                                coverage)
                                                               
								Shipping: _______________

                          				     Grand Total: _______________