VENUS HARP ORDER FORM

CUSTOMER NAME _____________________________________________________

STREET ADDRESS: ____________________________________________________

CITY: _________________________ STATE: _______ ZIP CODE: _______________

COUNTRY ____________________________

HOME PHONE: ______________________ WORK PHONE: ____________________

FAX: ____________________________ EMAIL: _____________________________


HARP INFORMATION

HARP MODEL: ____________________ FINISH: _____________________________

DECAL ON SOUNDBOARD: YES _______ NO _________

HARP SERIAL NUMBER (inventory, if known): __________________________

*BRONZING HIGHLIGHTS: ______________________________________________

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*ADDITIONAL REQUESTS: ______________________________________________

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AUTHORIZED TRADE-IN (include make, model, ID#, Finish, and agreed Trade-in Value)

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FINANCE PLAN (if chosen): ______________________________________________


OPTIONAL ITEMS (Available at additional cost)

___ ADJUSTABLE ROUND WOODEN STOOL $295.00
___ FOLDING BENCH $51.00
___ HARP CADDY (CART) $325.00
___ WATERPROOF BASE COVER sm/med $125.00 or lg $135.00
___ WATERPROOF COLUMN COVER sm/med $95.00 or lg $100.00
___ Adjustable multi purpose Music stand (black) $65.00
___ Adjustable Music Stand (black base,wood top) $78.00
___ Flip top wood music Bench (not adjustable) $139.00

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TOTAL PURCHASE PRICE DOES NOT INCLUDE SHIPPING CHARGES

* at an additional cost if not standard