This is a sample of our order form. When you order from CEL, please check one area in each category. For additional instructions, please use the bottom of the order form. Also feel free to forward any audiograms or other essential information with your order. CUSTOM EARMOLD LABORATORIES INC. TYPE OF MOLD MATERIAL 1. Regular (Body Aid) 2. Shell 3. 1/2 Shell 4. Invisible (Skeleton) 5. 1/2 Invisible 6. 1/4 Invisible (Canal Lock) 7. Ear Plug 8. Ear Plug (with handle) 9. Accoustic Modifier 10. Non-Occluding (Cross) 11. Non-Occluding #3 (with extended tubing) 12. Lybarger 13. Free Field TYPE OF AID Make: Model: 1. Silicone tinted 2. Silicone flesh 3. Super Soft 4. Softex 5. Rubbertex 6. Protint clear 7. New Ultra-sil 8. Dartex (Brown) 9. Lucite 10. Lucite Bowl-Soft Canal 11. Lucite Bowl-Audiflex 12. Lucite Tinted 13. Medical Flesh 14. Lucite Brown VENTING BORE Parallel Diagonal Small 1mm Medium 2mm Large 2.5mm SAV 1. #3 Bore (3mm) - open bore, fish mouth 2. #4 Bore (4mm) - Large TUBING Size or Type Standard Thick Wall Super Heavy #13 Reg. #15 Small 3mm Libby Horn 4mm Libby Horn CFA CFA Reverse bore Tube lock with gold sleeve Moisture freed (dry) tubing Yes ____    No ____ Additional Instructions: Dispenser Stamp