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Call 603 659 5335 or email me

1987 - 2017: Thirtieth Anniversary!
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Mail Order Form
(enclose this portion inside package)

Name: ______________________________________________________________________

Address: ____________________________________________________________________

City: ________________________________________ State: ______ Zip: ___________

Phone: ___________________ Email: ________________________________________

Brand and model of speaker:_____________________________________________________

DescriptionQuantityPriceTotal
______________________________________________
______________________________________________
______________________________________________
Subtotal_________
Shipping_________
Total_________

Method of payment (please check one):
Check or Money Order _____ MasterCard _____ Visa _____ Discover _____ Paypal _____

Card Number: _______-_______-_______-_______ Exp. Date: ___/___ CCV #: _______

- - - - - - - - - - - - - - - - - - - - - (shipping label - cut here and affix to outside of package) - - - - - - - - - - - - - - - - - - - - -
From:
____________________
____________________
____________________

To:
HUMAN Speakers
7 Kelsey Road
Lee, NH 03861




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