WISHBASS Custom Instrument Order Form

Make checks or MO to wishbass, 1245 Ivy Ave, Room 201, Winston Salem, NC 27101
Name_______________________________________________________

Address_____________________________________________________

Email______________________________________________________

Instrument__________________________________________________
Body Style__________________________________________________
Number of Strings____________________________________________.
Neck Wood_________________________________________________
Reinforcement None( ) Steel( )  Adjustable Truss rod ( )

Fingerboard wood____________________________________________

Side Dots Y / N ____Fretted Y / N_____

Body Wood_______________Top______________Back_____________

Controls____________________________________________________
Front / Back

Cover plate_________________________________________________
Bridge_____________________________________________________
Tuners_____________________________________________________
Pickup (s___________________________________________________
Other Hardware______________________________________________

Notes.______________________________________________________


____________________________________________________________

Start Date__________Deposit______________..
Payment______________.Shipped_________________