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Brite Ears LLC Specialized Hearing Systems:
Accessory Order Form

Client Information


Client Name
Ship to:
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Product Information

Foam Ear Plugs

S-PAK 60 pair / package Enter number of packages at $20.00/package
E-A-R Classic Packaged 200 pair per box / 25 pair per bag number of boxes at $42.00/Box of 200 or number of bags at $15.00/Bag of 25
E-A-R Express Pod Plugs Packaged 100 pair per box / 25 pair per bag number of boxes at $60.00/Box of 100 or number of bags at $20.00/Bag of 25
E-A-R TaperFit 2 Packaged 200 pair per box / 25 pair per bag number of boxes at $42.00/Box of 200 or number of bags at $15.00/Bag of 25 E-A-R soft Fx Packaged 200 pair per box / 25 pair per bag number of boxes at $42.00/Box of 200 or number of bags at $15.00/Bag of 25

Special Instructions

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

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		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.

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All Rights Reserved. Last modified: 09/29/2008