Combi 9100-0 instruction manual Parts Order Form, Price Quantity Total

Melody

Bouncer 9100 Series

Parts Order Form

If you would like to place an order for the following parts, please fill out the form below and return it to the following address:

COMBI International Corporation	or Fax this completed form to us at
Attn: Customer Service Department	630-871-0606
199 Easy Street
Carol Stream, IL 60188

IMPORTANT: We must have this information to process your order:

Model Number: 9100-0

Parts List for the Melody Bouncer Model 9100-0

			Price	Quantity	Total
1.	Seat Cushion		$ 15.00
2.	Canopy		20.00
3.	Speaker Set		10.00
4.	Complete Toy Bar including all 3 toys		15.00
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If you need to order other parts for your stroller, please call us			Amount of Order
toll-free at 1-800-992-6624.			Sales Tax (7.25%)
Shipping and Handling Fees: Add $5.00 for orders $34.99 and			(IL residents only)
under.Add $10.00 for orders $35.00 and over. Note: Additional ship-			Total
ping charges will apply outside of the Continental U.S.
		■ Charge to my credit card:
Ship To:		■ VISA		■ MASTERCARD
		■ AMERICAN EXPRESS		■ DISCOVER

Customer Name

Card Number

Street Address

Expiration Date ■ ■■- ■ ■■

Street Address

Cardholder’s Signature

City, State, Zip

■ Check enclosed

Telephone Number

9/5/2003

COMBI International Corporation • 199 Easy St. • Carol Stream, IL 60188 • www.combi-intl.com Customer Service 1-800-992-6624 • 10:00 a.m. - 5:00 p.m. Central Time • Monday - Friday