Cellular Systems Order Form

Cellular Systems Ear-Bud Systems (Please identify which Chameleon Ear color preference you want below) Ear-Bud Mold (sent w/consumers personal ear-bud) - $50.00 ea Ear-Bud System (w/generic ear-bud system) - $95.00 ea Plantronics Systems Plantronics Custom Ear-Bud - $45.00 each Plantronics 140 Series - $45.00 each Plantronics 145 Series (w/easy volume and mute switch) - $50.00 each Connection Adapter for Nokia 2100 Series - $30.00 each Connection Adapters for Nokia 5100/6100 Series - $30.00 each Connection Adapters for Ericsson Series - $50.00 each Connection Adapters for Ericsson 600/700 Series - $30.00 each Connection Adapters for Motorola Series - $30.00 each Starkey Earset Motorola Custom EarSet with 2.5mm adapter - $125.00 ea Nokia Custom EarSet with 2.5mm adapter - $125.00 ea Motorola Custom EarSet with Noise Cancellation and 2.5mm adapter - $175.00 ea Nokia Custom EarSet with Noise Cancellation and 2.5mm adapter - $175.00 ea
Chameleon Ear - Solid Ear Plugs (Select color below) - $90.00/set Standard (no color change) Deluxe (with color change) Floatables (not available in Illuminear) Illuminear (Glow) (Available in yellow-green only, can be swirled)

Color Choice for Chameleon-Ears

(For swirl, pick up to five colors. Changing and non-chagning (standard) colors can be swirled.)

Standard:	Red	Orange	Yellow	Green	Blue	Black
	White	Pink	Peach	Clear (Not available in floatable)

Color Changing: (Pick one starting color and one "changes to" color from the same line.)
Starting Color:	Changes to:
Vermilion ............	White	Yellow	Orange	Pink
Brilliant Rose ......	White	Yellow	Orange	Pink
Fast Blue ............	White	Pale Pink	Pale Orange	Pale Green	Pale Blue
Brilliant Green ....	White	Yellow	Orange
Fast Black ..........	White	Yellow	Blue
Purple ................	Blue	Pink
Brown ................	White	Silver	Gold

Glitter:	Red	Orange	Yellow	Green	Blue
	Orange	Black	White	Silver	Gold

Specialty:

Ear-bud Chameleon Ear (please provide personal ear-bud from walkman or cell-phone for perfect fit) $85.00/set

Special Instructions


If you have any special instructions, please explain in the space provided:

Payment Method


Personal Check Company Check Visa MasterCard
Account Name
Account Number		Exp. Date /
		All orders will be sent UPS Ground unless specified above. Foreign countries, please contact us before ordering.


To submit an order, fill out this form, print it, and then either fax it, or mail it to: Brite Ears LLC P.O. Box 6358 Akron, OH 44312 USA Phone: (330) 618-8913 Fax: (330) 784-8884 Click here to go back to the order form list

For more information click Information Request Form and we will be happy to contact you.