Special Order and Custom Work Form

Order form to authorize a special order or to have custom work done.

I ___________________________________ am using the Guitar Hangar to act as my agent and order for me and or modify for me a ____________________at the following price___________ . I understand that this is a special order that is non cancelable and full payment is due upon item's arrival to the Guitar Hangar unless other arrangements have been made in writing prior to this document . If this is for Custom work done to a guitar or amp, I understand that full payment is due upon completion of work. I also understand that in the event that I do not pick up the above item I forfeit all deposit money left at the Guitar Hangar. If deposit is left on a credit card, I will not seek a refund from the Guitar Hanger or request a charge back for the amount left on deposit for any reason. Any item left at the Guitar Hangar for more than 90 day's will become the property of the Guitar Hangar and may be sold to pay for work done to the guitar or amp and any storage fee's and late fee's that may apply. Storage fee's are 10.00 per week per item. Late payment fee's are 2% of delinquent balance per month. I agree to the above conditions.

Signed___________________________ Date_________________________

Name___________________________________________________________
^{(please print full name)}
Address_________________________________________________________

City _________________________ State__________ Zip_______ Phone (______)_______________

CC # _______________________________________ Exp___________

Name on CC________________________Type of card__________________
(as it appears on card) (visa/mc/amex/disc)

E-mail address___________________________________________

Please fill out and fax to 203-740-2730