Nagys Audio - Order Form

First Name: _______________________________________________

Last Name: ________________________________________________

Street Address: ___________________________________________

City: _____________________________________________________

State: ____________________________________________________

Country: __________________________________________________

Email: ____________________________________________________

Email will be sent (with tracking number, if applicable) when order is shipped.

Unelectric Loudspeaker Type (i.e. 2-way monitor, 2.5-way tower): ___________________________________________________

Unelectric Loudspeaker Quantity (i.e. single, pair, etc.): ___________________________________________________________

Unelectric Louspeaker Cabinet Finish (i.e. black, maple, cherry): __________________________________________________

Cable Quantity (i.e. single, pair, etc.): _________________

Cable Length (in meters): _________________________________

Speaker Wire Termination (spades 7mm opening, spades 9mm opening, straight spring bananas, right angled locking bananas):

___________________________________________________________

GOLDMUND A1/A2 Module Quantity: ___________________________

Goldmund Mimesis 3 Clone Amplifier Board Quantity (one board = one channel, two needed for a stereo amplifier): ________

___________________________________________________________

Preferred Shipper ($9): ___________________________________
	      (USPS Priority Mail, UPS Ground, FedEx Ground)
(Unelectric monitor/tower, please contact for rates)

International orders will be shipped via USPS Global Express. 
($30) (Unelectric monitor/tower, please contact for rates)

If ordering from Illinois, please add 9.75% sales tax.

Total Amount Enclosed: ____________________________________