2021 Northeast Comanche Tribe
 Shoulder Belt Group Buy Survey

Survey Questions:
The Northeast Comanche Tribe is working on possible Shoulder Belt Group Buy. If you are interested in participating please fill out the survey below.

Yes No

 * Do you want to buy shoulder belts within the next 90 days as part of a
    group buy?
Yes No  * Would you be interested in buying at a later date?
Contact Information - - - - - - - - - - - - - - -                   * field required
  * Name      * Phone
    Street address
  * E-Mail
     Aircraft           Year
Requests or comments :


This order form will be forwarded to Robert Klein.  It is for survey purposes only, and as such is not
binding on any party.  You will be contacted at the the phone number or e-mail address you provided.
**  contact information will not be shared  **