Wegen Picks Order Form

Please fill out and print this form and send it, along with your payment to:

Michel Wegen P.O. Box 119 7240 AC LOCHEM The Netherlands

All prices include shipping. For custom made picks, please fill in your name, e-mail address, etc., and write down your wishes on the back of this order form, if neccesary, enclose an example of a pick.
Accepted payment methods (other currencies please send an e-mail to michelwegen@wxs.nl first):
- cash: US Dollar($) or Euro(€)
- ask michel how to pay online

	Price Each	Quantity	Options *	Total Price
Gypsyjazzpick	$/€ 15,-		WhiteBlack
Fatone	$/€ 15,-		WhiteBlack
GP 250(2-pack)	$/€ 25,-		WhiteBlack
Twins(2-pack)	$/€ 20,-		WhiteBlack
4-pack Bluegrass 1.0mm	$/€ 15,-		White with grip holes White without grip holes Black with grip holes Black without grip holes
4-pack Bluegrass 1.2mm	$/€ 15,-		White with grip holes White without grip holes Black with grip holes Black without grip holes
4-pack Bluegrass 1.4mm	$/€ 15,-		White with grip holes White without grip holes Black with grip holes Black without grip holes
4-pack Bigcitypicks	$/€ 20,-		WhiteBlack
M 100 (3-pack)	$/€ 15,-		WhiteBlack
M 150 (3-pack)	$/€ 15,-		WhiteBlack
Trimus 250	$/€ 20,-		WhiteBlack
Trimus 350	$/€ 20,-		WhiteBlack
Trimus 500	$/€ 25,-		WhiteBlack
TF 100 (2-pack)	$/€ 15,-		WhiteBlack
TF 120 (2-pack)	$/€ 15,-		WhiteBlack
TF 140 (2-pack)	$/€ 15,-		WhiteBlack
T-shirt	$/€ 15		S(mall)   M(edium)   L(arge)   X(tra)L(arge)
			Total

Your Name
Address
Country
Phone (including int. access code)
E-mail:
Check for custom order ==>	Specify order at backside of the printed form