Name Complete Email Address (needed for confirmation) Street Address (Line 1): Address (Line 2 - if needed): City State Zip Phone Number Fax Number	Name of Speaker Size of Speaker 6  8  10  12  15 If the speaker you are sending has the surround doped, do you want it doped when it is reconed? Doping reduces the character and texture of a speaker and increases the break in time on most speakers, but reduces the chances of cone cry and ghost notes. Doping also extends the life of a speaker. No Doping Light Doping Moderate Doping Heavy Doping Same Doping as Original Color of Speaker Numbers or markings on the speaker frame or magnet
Next, you may decide method of payment. Please select a credit card or Check/MO if you have contacted us for a total and are enclosing a check or money order with the speaker. The information you enter here will not leave your computer and is used solely for printing this form on your computer printer. For Paypal, we will email you with the total and also give you our Paypal address.
Payment Method: Mastercard  Visa  Discover Check or Money Order Paypal
Credit Card #    Expiration Date    Credit Card Verification Number (a three or four digit number on the front or back of the card)

Comments and Special Instructions Regarding Your Recone