ALADO FAX FORM

Please, print (or copy) this form, complete 
and fax to (972) 484.6343 (USA)

Name:
     ______________________________________________________________

Delivery address:
     ______________________________________________________________

Phone:
     ______________________________________________________________

Fax:
     ______________________________________________________________

E-mail:
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Please, specify your ALADO furler:

	MODEL     TYPICAL      MAX. STAY    MAX. STAY  PRICE   
	NUMBER      LOA        DIAMETER      LENGTH       ZONE 1
	
[__]      A0        20'          1/8"          30'         $645

[__]      A1        25'          3/16"         35'         $780

[__]      A2        32'          1/4 "         40'         $915

[__]      A3        36'          5/16"         50'        $1495

[__]      A4        40'          3/8 "         55'        $1825

[__]      B1        40'          3/8"          55'        $2230

[__]      B2        50'          7/16 "        65'        $2555

[__]      B3        60'          1/2"          75'        $2880

[__]      B4        70'          9/16 "        85'        $3205

International Credit Card:

[__] MASTERCARD
[__] VISA
[__] AMERICAN EXPRESS

Card Number:
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Expiration date:
     ______________________________________________________________

Observations:
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