Order Parts

Dogpatch Music Instrument Repair Request Form

9-12 Rashik Hazari Lane

Chattogram, Bangladesh 4203

Store TEL:  1732 959 934

 ** Cut and paste information below into an email or doc, fill out the info and send it back to mohammad@dogpatchmusic.com.

Date of Order Request:

 

Estimated Date/Need by Date:

 

Tour/Gigs/Travel Plans:

 

 

SECTION  I - INSTRUMENT INFORMATION

Instrument Category

 

Select Type

 

Strings

 

Percussion

 

Brass

 

Wind

 

Keyboards

 

Electronic

 

Folk/World

 

Other (If other provide notes below)

 

Instrument Detailed Description:

   

Instrument Brand Name:

 

Instrument Model Name:

 

Instrument Serial #:

 

Purchased Origin (On-line, Store, 2nd hand)

 

 

SECTION II - CONTACT INFORMATION

Requestor’s First Name

 

Requestor’s Last Name

 

Name of Institution /Corporation if Applicable

 

Address Line 1/ Street Name

 

Address Line 2 / Street Number

 

Postal Code

 

District Name

 

Next to Business Entity

 

Building Name

 

Near/above Building or Landmark

 

Other Known Place/Location

 

Suite #

 

Apt #

 

Floor #

 

Telephone # Home/Primary

 

Telephone # Mobile

 

E-Mail Address 1

 

E-Mail Address 2

 

Special Instructions if delivery

   

 

PART(S) REQUEST ORDER INFORMATION

Description of Instrument

 

Line Item #

QUANTITY

MANUFACTURER PART NUMBER

SKU # Code #

MANUFACTURER (Preferred or other Brand Part# substitute)

Unit Price List

1

 

 

 

 

 

2

 

 

 

 

 

3

 

 

 

 

 

4

 

 

 

               

 

5

 

 

 

               

 

6

 

 

 

 

 

Additional Information

 

 

SECTION III – SHIPPING OR PICK UP OPTIONS (Pick up part at the store or ship to your location)

 

Select from the following options below:

1

Pick up parts at the store 

 

                Get part(s) cost estimate before ordering

 

                Get notifed by e-mail or Call if part is unavailable or back-order

 

                Get your approval If substitute parts are available prior to ordering

 

                Get notified by e-mail or Call if repair estimate has changed

 

                Get notified by e-mail or Call if part delivery date is delayed or no ETA

2

Ship Parts to your location

 

                Get part(s) cost estimate before ordering

 

                Get notifed by e-mail or Call if part is unavailable or back-order

 

                Get your approval If substitute parts are available prior to ordering

 

                Get notified by e-mail or Call if repair estimate has changed

 

                Ship parts to the address/location provided via courier

 
SECTION IV – SEND US PICTURES OR VIDEO

Send pictures to mohammad@dogpatchmusic.com

 

SECTION V – PAYMENT INFORMATION

  • Price listed do not include cost of replacement parts

  • Any items left in the store must be accompanied by a Dogpatch Music Repair form

  • Actual rates may vary and are subject to change based on part’s availability, etc.

 Change in estimate/work:

  • You will receive a call from Dogpatch Music Services with estimates and timeline for repairing your gear.

  • If we need to order part(s) we will contact you prior to ordering and provide a revised estimate

  • If the level of effort or part of the repair service estimate changed prior to the original estimate due to unforeseen cracks, defects, etc. we will contact you directly.

  • We accept payment by phone with B-Kash, Credit Card (Visa, Mastercard, AMEX) or Cash-On- Delivery.