Unbucker 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 = $260.00/set
Single Neck Pickups: select how many?	N/A 1 2 3 4 5 Necks = $130.00 each
What output for the neck?	Select Output ** 4.5K 4K 5K < Higher output coil Select Output ** 2.5K 2K 3K < Lower output coil ** = Recommended Values
Single Bridge Pickups: select how many?	N/A 1 2 3 4 5 Bridges = $130.00 each
What output for the bridge?	Select Output ** 5K 4.5K 4K < Higher output coil Select Output ** 3K 2.5K 2K < Lower output coil ** = Recommended Values
What type of lead?	Gibson braided shield 3 conductor w/shield or 4 conductor w/shield
What color humbucker do you need?	Black Zebra
If you are getting covers what color?	N/A Nickel $10.00 extra Gold $12.00 extra
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, Fax: 804-358-3431
Unbucker Order Form