PLEASE READ THIS BEFORE FILLING OUT THE FORM BELOW

Name:
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Email:
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Studio Name:
*

Studio Address: Street address, city, state, & zip code:
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Contact Phone Number:
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Questions or Comment:


* = Required

Frame Style:
- Choose One - Will write in comment area the machine reference number off the web site C.01 C.02 C.03 C.04 C.05 C.06 C.07 C.08 C.09 C.10 C.11 C.12 C.13 C.14 C.15 C.16 C.17 C.18 C.19 C.20 H.01 H.02 H.03 H.04 H.05 H.06 H.07 H.08 H.09 H.10 CAST FRAME Horse Shoe "U" Shaped Horse Shoe "J" Shaped

Machine Type:
- Choose One - Liner -Short Stroke Liner - Medium Stroke Liner - Long Stroke Shader -Short Stroke Shader - Medium Stroke Shader - Long Stroke

Frame Finish:
- Choose One - Plain Finish -BLK- 1/2 Engraved Fully Engraved High Detail Engraved ( 1/2 ) High Detail Engraved (Fully ) Brass Inlays 1/2 Engraved with Brass Inlays Fully Engraved with Brass Inlays

Other Frame Options:
- Choose One - NONE Rear Spring Saddle Support Holes Drilled In Side Plate Both

Coil Set:
- Choose One - 6 - Wrap 7 - Wrap 8 - Wrap 9 - Wrap 10 - Wrap

Coil Covers:
- Choose One - Vintage Tape - BLK Cloth Tape -BLK Electrical Tape - BLK Clear Shrink Wrap Shrink Wrap - BLK Clear Tape - Tinted Old Money Silver ( Shiny ) Gold ( Dull ) Gold Fish Tape Silver Fish Tape Green Fish Tape Red Fish Tape Exotic - BLK (Gator) Exotic - Brown (Croc.) Snake Reptile

Machine Hardware:
- Choose One - Brass Screws Steel Screws Allen Head Screws Button Allen Head Screws - Choose One - Brass Washers Steel Washers Copper Washers - Choose One - Silver Contact Screw Copper Contact Screw Brass Contact Screw