ORDER FORM
For Aurora Design FMR Stereo Conversion
STEP ONE: Who you are (Rest assured, we do not solicit, nor share information)
Name: _____________________________________________________________________________________________________________
Business Name If Applicable: ______________________________________________________________________________________
Shipping Address: _________________________________________________________________________________________________
City, State or Province, ZIP or Postal Code: ________________________________________________________________________
Phone: _____________________________________________ E-Mail: ______________________________________________________
STEP TWO: What you need
Car Radio year, Make, Model: ________________________________________________ Voltage: ________ Polarity: _______
Options:
Bluetooth Options:
________ NEW! BTU Smart -- Bluetooth 5.0, USB 2.0, Ability to adjust radio settings from phone ($260)
________ BTU -- Bluetooth 5.0, USB 2.0 ($220)
________ BTC/BTL -- Bluetooth 5.0 By Itself ($170)
Other Options:
________ USB Module -- USB 2.0 By Itself ($100)
________ HD Radio -- Digital Radio (or DAB/DAB+ if configured for European Tuning) ($120)
________ CM-1 Courtesy Module -- 12v only -- radio plays until door is opened ($75)
________ VOX Input Mode (Default is tune to the left) (No Cost Option)
________ HPC Booster -- Required for 6 volt and/or positive ground ($100)
Additional Instructions: (Must be approved in advance) ________________________________________________________
__________________________________________________________________________________________________________________
STEP THREE: Payment Information -- Required prior to service
Credit Card: MC, VISA, DISC, AMEX
Card Number: ________________________________________________________________________________________________
Expiration: _____________________________ CVV Code: __________________ Billing ZIP Code: ____________________
As an alternative you may call us with your card information. However don’t wait for us to call. This could result in a
major delay, as we handle a LOT of radios! Credit cards are authorized when we begin, charged when completed.
We also accept checks. Please call to verify correct amount.