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PHONOGRAPH GRILL ORDER FORM

TO ORDER PHONOGRAPH GRILLS: 

Please provide the following information so that we can furnish the correct type and size of grill for you.  You can fill in the form here on line or just print it out and mail it.  Please send us a check or money order to confirm the order.

The grill will be made to fit the specific dimensions you list here. Measure carefully and contact me if you are unsure of the measurement procedures.  If have any questions, please contact me or mention them in the notes.

TO ORDER OTHER PARTS please click here

SHIPPING:
Most of these items are made to order so please allow 3-4 weeks for delivery.  Please add $7.00 per grill for insured domestic shipping. Add $2.00 for each additional grill. Call for non domestic shipping rates.

IMPORTANT: Use the TAB KEY to move to the next box.  Use shift TAB to go back. 
If you hit enter to soon just use your back key and start again.
Name
Company (If applicable)
Address
  Phone    E-mail
Phonograph
Model:

 
Make and model # if possible.
Case
Material:

   Other:

Quantity:

  Number of grills.

Opening Dimensions:

It is important
that these measurement
be precise.

Opening Size
 This is the size of the actual opening in the phonograph itself. 
      Height:     Width:

Groove Size
This is the measurement of the groove that is in the top and bottom of the opening that the grill (or grill and frame) fits into. See cross section A on the drawing.
Top Groove:     Depth:    Width:
Bottom Grove:  Depth:    Width:  

Notes:

How did you find our site?

Type validation text here as it appears in red 3405LAK

SUBMIT ORDER when finished =

If you would like another grill just Reset Form after you have submitted the first request and change the product information and then submit it again.

Send Check or Money Order to confirm your order to:

 Tom Rutkowski, 3405 Lakeshore, Lexington, MI  48450   Phone: CompanyPhone, FAX:  810-359-2430  
 Email:  CompanyEmail

TO ORDER OTHER PARTS (besides grills) please click here