Swordcanes Order Form

Burger Custom Canes Order Form

Thank you for your order confirmation, by completing my secure order form I would just like to confirm that no debits/transaction will take place on your CC, until I have made contact with you, regarding a full break down of your order details and you have agreed to all costs and details of your order. Thank You, Barry Burger -Maker

* How / where did you hear about Burger Quality Canes? (Please select option below) : *

For "Other", please specify

Notes or Comments

Model Choice *

* Handle Choice (Please note our standard Turned Tamboti and Tee handles are included in the price of your qulaity Burger Cane. Our more unique custom handles add to the price of the cane) *

Turned Tamboti - most popular & practical handle (Ball & Flute style)

Tee Handle

Custom Tee Handle in Warthog Tusk Ivory with S/S end caps and titanium spigot- Starting at $1100-

Impala Horn (Adds $450-00)

Pistol Grip Warthog Tusk (Adds $450-00)

Hand Cast Nickel Silver (Adds $450-00)

Custom Hand Cast Sterling Silver 4.9 oz/140 grams starting at $1100-00 - (Ball & Flute style)

Unique Hand Turned Titanium (Adds $450-00) Larger Hiker/Country Cane Ti Handle adds $100-

I would be interested in personalized custom engraving of initials/name/logo on my handle or blade (starting at $160-00).

Length

Standard Length (36" / 92cm will suit person of average height)

Alternate length

For alternate length please specify in inches or metric

Shaft Finish

Matt Black Carbon

Woven Carbon

Break Down Conversion (Adds $200-00) Recomended, if you see yourself using this option frequently when traviling with your cane.

Yes

No

Shipping Information

* First Name: *

* Last Name: *

* Street Address: *

* City: *

* State / Province: *

* Zip / Postal Code: *

* Country: *

* Phone #: *

* Email Address: *

* Confirm Email Address: *

SHIPPING - We ship our quality canes to all four corners of our "global village", and assure you of very discreet and trouble free delivery of your order. Delivery is a discreet 5-6 day door delivery, once I have received your confirmed order form I will follow up with final shipping costs and estimated shipping date.

Is your credit card billing address the same as your shipping address?

YES

NO

If your answer above is "NO", please indicate your credit card billing address :

Name on Card

Credit Card Type (Please note DEBIT CARDS not accepted)

Card No (i.e. 1234-1234-1234-1234)

-

Expiry Date (i.e. month - year)

CV # (Last 3 numbers on back of card/ For Amex four numbers on front of card)

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