LEDress Order Form

( If ordering more than one unit, write plainly on this form what you want,
or print more copies of the form.  Total the prices. )

Your LEDress display numbers: __ __ __ __ __

Enclosure style: ( circle one )

	HORIZONTAL ( display numbers are side-by-side )

	VERTICAL   ( display numbers read top-to-bottom )

Color of Enclosure: ( circle one ) WHITE     GRAY    BLACK

Color of LEDs: (circle one) RED  GREEN  ORANGE  YELLOW  BLUE  WHITE

Price of LEDress unit:                   $ ________ (See "pricing"  webpage)


Mounting Kit (enter $4)                  $ ________ (See "mounting" webpage)

Wiring Kit ( 20 cents/foot x ___ feet) = $ ________ (See  "wiring"  webpage)

Total dollar amount of this order:       $ ________

If using wiring kit, wire staples color: ( circle one )   WHITE     BROWN

Ship-to Name:     ____________________________________

P.O. Box or
Street Address:   ____________________________________

City, State, Zip  ____________________________________

E-mail Address:   ____________________________________
(email is optional: for sending order confirmation and shipping dates to you)

Today's date:     ____________________________________

Make payment out to:  The Logician, LLC

Send this form and payment to:

	The Logician, LLC
	4833 SE 47th Avenue
	Portland, Oregon 97206

Thank you--this order will be given prompt attention.