Analog Man Other pedal Modification Order Form

Please first fill out the info below, then print it and send it to me with your pedal to modify.
Choose your pedal type from the list box on the left if it is there.

or other type and $:

Serial No.   Sent in orig Box? with Battery?(I recommend sending without battery)

                  Options
            Customer fill out this side
$15 add LED (needs bypass switch)
Led color Red, Yel, Grn, Blue
$15 add Boss type 9V power jack
$    Fuzzface trans (see buyanalogman)
$10 Fuzzface Silicon (rev polarity)
$50 EXP Pedal mod, knob:
$130 Expression mod and EV-5 pedal
$15 New 9vDC power supply
$15 New Stomp switch (if not included)
$5 or Two for $7 Keychain Bottle Opener
$20 "FUZZ" DVD
$10 TShirt s/m/L/XL Red/Blu/Blk
$3 Analog Man Koozie can cooler, or 2/$5
(Analog Man use only)

Date in by logged
$ and order correct
collected
pedal tested OK before mod
completed mod on
Mike OK'd for final test and ship:
final tested on

Other charges, such as repair (please detail):

TOTAL CHARGE included (please add options and shipping):

Return shipping info : Your name :
Address :
Address :
City : State :     Zip:
Telephone(s):
Country: Email:

After filling out the form, please print the above on one page if possible, (BE GREEN!) and include it with your pedal. Internet Explorer prints best. The PRINT button may not work with older browsers, then select File Print in your browser. See below for shipping and payment information.

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SHIPPING:

Please send a money order (postal or bank money order) for the total above, made out to "Míke Píera". Or if it's easier, just put $US cash in the battery compartment, it will be OK. No checks, please, as I don't want to hold your pedal until a check clears, except Wells Fargo or Webster Bank checks are fine. Please send the pedal and $$ to :

Míke Píera
Analog Man
1 Garella Rd Unit D
Bethel, CT 06801

Use this add ress for fastest service. You can send it by US Priority mail, they can even provide a folding box you can use (put in lots of balled up newspaper or bubble wrap all around the pedal). UPS or FEDEX are fine too. From overseas please use air mail, not UPS or FEDEX or others to avoid making us pay ridiculous customs and brokerage fees.
*** We will REFUSE any package that comes in from out of the USA by UPS or FEDEX. I'll get it converted within a few days (normally 2-3 days).

Regards, mike ~^v^~ aNaLoG.MaN ~^v^~ vintage guitar effects

http://www.analogman.com