Please fill in the following blanks. Include the number of each item desired.

HD-3           HD-4     HD-5    HD-5C    HD-6   
HD-6C    HD-7    HD-9    HD-10    HD-11   
HD-11C    HD-12    HD-12C       
First Name: Last Name: 
Street:

City:

 State: Zip:

Phone Number: 

E-Mail Address:

We are happy to accept Mastercard and Visa.

Card holders name: 

Card #: ---    Exp. Date: 

We will bill you for the total amount plus 7 to 10% (depending on destination) for shipping and handling*.

If you have any additional questions or comments, please let us know in the box. When everything is complete, submit it! Thanks and enjoy your new lights!                                      

 

* The 7-10% is for all items shipped within the continental United States. Mass residents must also pay 5% tax.

Or if you want to ask a question: bnb@brassandbounty.com

brassandbounty.com

 

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