Name:________________________________________________

Address:______________________________________________

City:__________________State:______ Zip:_______-_______

Phone:_____________________________________________

E-Mail:____________________________________________

Flute(s), Key(s) you would Like:________________________________

Wood you prefer:____________________________________________

Price(see prices or call me):____________________________

MD Residents add 5% sales tax:_______________________

Total:___________________

Please print the above form, fill out and enclose
a check or money order made payable to:

Douglas Moore
Mail to:
51 Baldridge Road
Annapolis, MD 21401

Please allow 6 weeks for delivery. Satisfaction Guaranteed
Flutes Mailed U.S. Priority Mail.