Musmate Products Order Form for the European Union  
Product Harness Size Shoe Size Quantity Price (Euro) Total
Complete Set for the Left Leg       124  
Complete Set for the Right Leg       124  
Complete Set for Both Legs       209  
Product Size Colour Quantity Price (Euro) Total
Left Leg Shoulder Harness       49  
Right Leg Shoulder Harness       49  
Both Legs Shoulder Harness       79  
Shoulder Pad       9  
Elastic Assembly       24  
Shoe Harness for Left Foot       40  
Shoe Harness for Right Foot       40  
Shoelace Connector       9  
_______________________ ____________ _______________ _______ _______ _________
Delivery Charge (less than 100 Euro, 15 Euro; otherwise 39 Euro)  
Total______________________________________________________________ _________
Name:
Address:
Telephone Number (in case of queries):
E-mail Address (in case of queries):

Payment
Please make cheques payable to Musmate Ltd.

Send Payment to:
Musmate Ltd, P.O.Box 3976, Bath, Somerset, BA1 0DF, UK. Telephone 0845 094 4674, fax 0845 094 4674,
e-mail
sales@musmate.co.uk
A company registered in England and Wales, No. 5671724.