Guitar Doctor

Printable Order Form

Instructions:
1) Print this form - use    if desired 
2) Please provide all information here - hand written is fine - we will telephone you to verify.
3) Mail or FAX to: 
Guitar Doctor
659 Bedford Street
Whitman, MA   02382  USA  or  FAX to 781-447-0523


NAME:_______________________________________________________________

SHIPPING ADDRESS:____________________________________________________

CITY:__________________________ STATE/PROVINCE:______________________

POSTAL/ZIP CODE:___________________ COUNTRY:________________________

TELEPHONE NUMBER:___________________________________________________ 

EMAIL ADDRESS:______________________________________________________

BILLING NAME & ADDRESS (if different from shipping address): 


     
Item Name and/or # How Many? Price TOTAL
       
       
       
       
       
       

Shipping, Handling & Insurance: Because all orders are so different in weight and distance, please phone 781-447-4520 or email for a quote. 
   

   

Special Instructions:

TOTAL

METHOD OF PAYMENT (check one): [ ] Money Order  [ ] Personal Check  [ ] Visa/MasterCard
 We do not accept Discover or American Express
For Credit Card order, include:
Credit card #:_________________________________________________________ 
3 digit security code from back of card (           )
Expiration Date:____________________________________________________
Card Holder's Name:__________________________________________________ 
Card Holder's Signature:_______________________________________________ 
Today's Date:___________________
 we will phone to verify age on all fax or mail orders                                 
                                                             Thank You for your Order