Strat® Style Split-Blade Order Form
Fill out this form, Print it out and Submit with your order (Feel free to make any notes necessary pertaining to 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 = $15 / Overseas Orders = Call for Quote
Sets: select how many you need?	N/A 1 2 3 4 5 Whole sets = $300.00/set
Single Neck Pickups: select how many?	N/A 1 2 3 4 5 Necks = $100.00 each
Single Middle Pickups: select how many?	N/A 1 2 3 4 5 Middle = $100.00 each
Single Bridge Pickups: select how many?	N/A 1 2 3 4 5 Bridges = $100.00 each
What type of Strat® Split-Blade do you need?	Vintage Blues Special High Output Super High Output
Pickup Radius?	Standard (7.25" to 9" radius fretboards) Flat (9.5" to 11" radius fretboards) Flatter (12" and Flatter radius fretboards)
What color covers would you like?	White Black
Total amount enclosed with this order?	$
Notes/Comments regarding your order:
Lindy Fralin Pickups, 2015 West Laburnum Ave. 2nd Floor, Richmond VA, 23227 Phone: 804-358-2699
Strat® Style Split-Blade Order Form