Musmate Products Order Form for the UK  
Product Harness Size Shoe Size Quantity Price (£) Total
Complete Set for the Left Leg       75  
Complete Set for the Right Leg       75  
Complete Set for Both Legs       125  
Product Size Colour Quantity Price (£) Total
Left Leg Shoulder Harness       30  
Right Leg Shoulder Harness       30  
Both Legs Shoulder Harness       50  
Shoulder Pad       5  
Elastic Assembly       15  
Shoe Harness for Left Foot       25  
Shoe Harness for Right Foot       25  
Shoelace Connector       5  
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Delivery Charge (less than £60, £2.50; over £60 £4)  
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.