Chicago Brass Works Order Form NAME:____________________________________________________________ STREET ADDRESS_________________________________________________ CITY______________________________________________________________ STATE_________________ POSTAL CODE_________________________ COUNTRY__________________________________________________________ PHONE____________________________ EMAIL_________________________ I WOULD LIKE TO ORDERING THE FOLOWING: TSB RAW - $2,090.00 ____ TSB SILVER - $2,290.00 ____ TSB GOLD - $2,940.00 ____ TSC RAW - $2,230.00 ____ TSC SILVER - $2,430.00 ____ TSC GOLD - $3,130.00 ____ TSCM RAW -$2,230.00 ____ TSCM SILVER - $2,430.00 ____ TSCM GOLD - $3,130.00 ____ TSN RAW - $2,380.00 ____ TSN SILVER - $2,580.00 ____ TSN GOLD - $3,380.00 ____ TSRH SILVER -$2,680.00 ____ TSRH GOLD - $3,300.00 ____ GSB RAW - $2,240.00 ____ GSB SILVER - $2,440.00 ____ GSB GOLD - $3,140.00 ____ GSC RAW - $2,370.00 ____ GSC SILVER - $2,570.00 ____ GSC GOLD - $3,270.00 ____ GSN RAW - $2,570.00 ____ GSN SILVER - $2,770.00 ____ GSN GOLD - $3,470.00 ____ GSBM SILVER -$2,540.00 ____ GSBM GOLD - $3,190.00 ____ Concierge Service $250.00 ____ (Personalized custom building w/customer participation) SHIPPING & INSURANCE ADD $37.00 per horn TOTAL AMOUNT ENCLOSED: $_____________________ PLEASE MAKE CHECKS PAYABLE TO: Chicago Brass Works 101 North Hickory Aveune Arlington Heights, IL 60004 RETURN POLICY: 5 day trial from the date horn is received. Must be returned in original condition within 5 days Buyer will assume all shipping charges. A restocking fee may apply. NO RETURNS ON GOLD PLATED TRUMPETS