Choose a UE Model and Color from: Pro.UltimateEars.com Name * First Name Last Name Phone (###) ### #### Email Address * * UE Model * Ambient Feature * $50 for each ear Less than 5% of people opt for this yes no Color * Cord Length * 50" Silver 64" Silver Bluetooth only 50" and Bluetooth +$100 Name on Case * Case Size * Small Square Round Case Status of Ear Impressions * Locate an Audiologist: http://pro.ultimateears.com/get-your-impressions First Order - Impressions to be sent Ordered Previously - Impressions already on file Ordered Previously- But still sending New Impressions Billing Address * Credit Card Information * Please Enter Card type (VISA, MASTERCARD, etc...) Card Number Expiration Date CVV Shipping options * Next Day Air Saver $10 Next Day Air $45 Shipping Address * All my information is correct, I checked. * Yes I Authorize, Billy Connolly, to place this order on my behalf * I Agree % * Thank you!You are on your way to hear for life!I'll be in touch!