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Order Form
                                  CLARFLUPET PRE-BAND PRIMERTM
                                            (ORDER FORM)
(PLEASE PRINT)

NAME:  ____________________________________________________________

SCHOOL / ORGANIZATION:  __________________________________________

ADDRESS:  _________________________________________________________

                _________________________________________________________

CITY:  ____________________________  STATE:  ______ ZIP:  _____________

PHONE:  _______________  E-MAIL:  ________________  FAX:  ____________

PURCHASE ORDER #:  _______________________________________________

                                                                                      QUANTITY      TOTAL

THE CLARFLUPET PRE-BAND PRIMERTM (PROGRAM KIT)  $1,600    ________    _________
    (A $200 Savings over items purchased separately.)
    Includes:      25 CLARFLUPETTM WIND EMBOUCHURE TRAINERS
            25 REEDS
            25 PAIRS OF 7A TRUELINETM POWER GRIP DRUMSTICKS
            25 GUM RUBBER PRACTICE PADS
            2   ACCESSORY BASKETS
            1   CART TO HOUSE AND TRANSPORT MATERIALS
            1   CLARFLUPETTM HANDBOOK / DVD
            1   CLEANING SYSTEM

PURCHASED SEPARATELY
    CLARFLUPETTM WIND EMBOUCHURE TRAINERS                       ________   _________
        ($45 each for 25+, $47 each for 11-24, $49 each for 1-10)

    TRUELINETM POWER GRIP DRUMSTICKS ($7.50 / pair)              ________   _________

    PURE GUM RUBBER PRACTICE PADS ($5 each)                        ________    _________

PRICES GOOD THROUGH THE END OF JUNE, 2008

                                                                 SHIPPING - ADD 10%:         _________

SCHOOL TAX EXEMPT #:  ____________________________    OR         TAX      _________

                                                                                           TOTAL     _________
Please make checks payable to: Clarflupet, L.L.C.
    Mail to:      Clarflupet, L.L.C.
            David Heintz, Manager
            79 Lime Kiln Rd.
            Pike, NH  03780

Phone / Fax:  603-989-5436        trptheintz@aol.com        www.clarflupet.com

CLARFLUPET ORDER FORM

For prices, please see the information listed above.

Name:
School / Organization:
Purchase Order #:
Tax Exempt #:
Address:
City:
State:
Zip Code:
Phone:
Fax:
E-Mail:
Item 1:
Quantity 1:
Total 1:
Item 2:
Quantity 2:
Total 2:
Item 3:
Quantity 3:
Total 3:
Item 4:
Quantity 4:
Total 4:
10 % Shipping and Handling:
Tax (if applicable):
Order Total:

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