ORDERFORMFORAX-2K4AX-2K4S,AX-2K4MS,AX-2K4MSFL
Attention: Transmitter Ordering
Department
Important: To help us expedite your order, please print all of the infor- mation legibly and mail this form and your payment according to the instructions below.
Indicate the pad number of your transmitter selected from the pads shown above.
Note: Transmitter model number found on back of case.
1)Pad Number:_________________________________
2)Name: _______________________________________
3)Address: ______________________________________
4)City: ________________ State: _____ Zip Code: ________
5)Telephone Number: (_____) _______________
6)Total Number Of Transmitters Required:
Cost Per Transmitter is: | $65.00 |
Multiply By Number Of Transmitters | X ______ |
7) Enter Total Amount Enclosed _________________
(New York State Residents must include the appropriate sales tax)
8) Method of Payment:
Mastercard Visa Check or Money Order (do not send cash) Make Checks Payable To Audiovox Corporation
Credit Card Number: _________________________________
Credit Card Expiration Date: ____ / _____ / _____
9) Mail this form along with your payment to:
Credit card purchasers can order additional or replacement
transmitters by phone. Simply dial 1 - 800 - 645 - 4994, and follow the instructions from the operator interface.
Audiovox Electronics Corp., 150 Marcus Blvd., Hauppauge, N.Y., 11788
Attn.: TRANSMITTER DEPARTMENT
© 2003 Audiovox Electronics Corp., 150 Marcus Blvd., Hauppauge, NY, 11788 |
128-6987
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