Reiki Drumbeat - Mail in Order Form

Please Print this Form and Fill it Out Clearly

YOUR INFORMATION

Name: _____________________________________________________________

Address:___________________________________________________________

City: ________________________________State: _______ Zip: ____________

Phone Number: ______________________Fax: _________________________

eMail Address : _____________________________________________________

DRUM INFORMATION

1.) Name of Drum: ____________________________________

2.) Diameter of Drum:_________________________________

3.) Price of Drum: _____________________________________

4.) Include Sales tax - PA Residents Only: ____________

5.) Shipping/Handling - Call or email for Cost, depending on location/zip code

6.) TOTAL COST: _______________________________________

If you want a Custom Drum, please give us the following information - We will follow up with a Price Quote:

1.) Type of Wood/ Finish for Frame: ______________________

2.) Type of Drumhead: ___________________________

3.) Diameter and Height: _________________________

4.) Additional Information: _________________________

Custom Made Drums require a Non-Refundable Deposit of 1/2 the cost of the Drum.

Please Mail this Form with a Check or Money Order to:
Cat Coley - 515 6th Street - Wind Gap, PA. 18091 OR Call 610.863.6764
If you have any questions or concerns about placing your order.