Make your check payable to Moritz Designs
 

Name  _____________________________  Phone Number  ______________________  Fax Number  ________________________  Email Address  ______________________  Street Address  ______________________  __________________________________  City  ______________________________  State  _____________________________  Zip Code  __________________________  Country  ___________________________  For our records, how did you find us?  __________________________________  __________________________________

Please send me the following SideKick Controller(s) and/or accessories:    Qty.   ___ 2-Pedal Controller x $24.95 ea.    _____   ___ 4-Pedal Controller x $38.95 ea     _____   ___ Add-on Footswitches x $7.25 ea. _____         + $3.00 shipping in the US            _____         + $6.00 shipping outside the US    _____                                 Total Amount    _____  All funds are in American Dollars (USD)

 Thank you for your order!

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