Strat® Replacements 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 Whole sets = $220.00/set
Single Neck Pickups: select how many?	N/A 1 2 3 4 5 Necks = $75.00 each
Single Middle Pickups: select how many?	N/A 1 2 3 4 5 Middle = $75.00 each
Single Bridge Pickups: select how many?	N/A 1 2 3 4 5 Bridges = $75.00 each
What type of Strat® replacement do you need? *ALL PERCENTAGES OVER REFER TO STOCK SPECS*	Vintage Hot Blues Special = 5% Hotter than Stock High Output 10% 15% Steel Pole 42 = 20% Over Stock Steel Pole 43 = 25% Over Stock
Do you need a baseplate on the bridge? *NOT AVAILABLE ON STEEL POLE*	Yes No
What type of magnet stagger? *NOT AVAILABLE ON STEEL POLE*	Stock Hybrid
What color covers would you like?	Bright white, Aged white (Yellowish), 60's Greenish tint, or Black
Total amount enclosed with this order?	$
Lindy Fralin Pickups, 2015 West Laburnum Ave. 2nd Floor, Richmond VA, 23227 Phone: 804-358-2699, Fax: 804-358-3431
Replacement for Strat® Order Form