- Order Form -

Print and Include with your check, money order, or credit card information:

Name: ___________________________________________________

Address: _________________________________________________

City: ______________________________ State: _____ Zip: ________

Day phone#: (___)____________ Evening phone#: (___)____________

Email address:_____________________________________________
Your email is used solely to contact you about your hearing enhancers and provide
updates and special information from Naturally Digital. We will not give your
information out to others.

How did you hear about us?__________________________________

I would like to order the following hearing enhancement units:

_____ Please send an impression kit with instructions to make impressions
for custom fit shells

_____ One set of Open mold, Over-the-Ear, Hearing Enhancers:
2 units @ $945 each; total of $1890.00

_____ One set of Custom Shell, in-the-canal, Hearing Enhancers:
2 units @ $945 each; total of $1890.00

_____ A set of Single Memory Hearing Enhancers:2 @ $387 each; total of $774.00

(This is the economy, single memory, one size fits all unit with the foam wraps).

_____ A set of Multi-Memory Hearing Enhancers: 2 @ $497 each; total of $994.00

(This is the economy, multi-memory, one size fits all unit with the foam wraps).

___ ONE Single Memory Unit for the ___ Left ___ Right ear $387 + $8 shipping;
total $395.00

(This is the economy, single memory, one size fits all unit with the foam wraps).

___ ONE Multi-Memory Unit for the ___ Left ___ Right ear $497 + $8 shipping;
total $505.00

(This is the economy, multi- memory, one size fits all unit with the foam wraps).

_____ One carton of 40 batteries $29 (4 batteries included with each new order)

_____One package10 foam wraps $10 (included free with all new in the ear unit orders)

Payment Information:

_____Check_____Money order_____ Paypal_____ Credit card

Credit Card Information: (do not fill out this part if you have paid online using the Credit Card buttons above)

____ Visa ____ Mastercard ___ American Express ___ Discover___ Optima

Card #: ______________________________________

Expiration Date: _______________________

Three Digit CVV Code ______ (on the back of card at the right end of signature)

Billing Adress (if different than shipping address)

Name: ________________________________________

Address: _______________________________________ City: ______________________________

State: _____Zip: __________

Additional Comments or Questions:

_________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________

Mail your check or money order to: Naturally Digital 12719 Riley Street PMB 162 Holland MI 49424 Or Call In Your Order for Fastest Service: 800-983-4345 Email Us: Rhenn@HearTheSoundsofNature.com Home Birdwatcher Basics Enhanced Hearing Devices Buy Online Backyard Bird Feeding How they Work Prices & Form Birdwatching FAQ Features and Benefits Identifying Birds Ordering Information Equipment Printable Prices & Order Form