P-Bass® Printable Order Form
Fill out this form, Print it out and Submit with your order
Your Name:
Daytime street address:
Daytime street address (cont.):
City, State, Zip Code:	, , -
Daytime phone number: (*Required for FedEX)
Shipping Rates: (*We only charge for 1st pound)	US Orders = $12 / Overseas Orders = Call for Quote
Sets: select how many you need?	N/A 1 2 3 4 5 $120.00/pair
NOTE: These pickups are wound to 10k.
Total amount enclosed with this order?	$
Notes regarding this order:
Lindy Fralin Pickups, 2015 West Laburnum Ave. 2nd Floor, Richmond VA, 23227 Phone: 804-358-2699, Fax: 804-358-3431
P-Bass® Printable Order Form