Model No. | Serial No. |
(Both Numbers Required) |
|
SHIP
TO:
Name
Address
Check or money order enclosed (payable to Century Products)
Charge to credit card
Visa MasterCard Discover
Account #
City, State, Zip Code
Expiration date
Telephone (including Area Code) | Signature |
|
Subtotal:
Fabric Seat Pad (All Models) | $35.00 |
Fabric Shield Pad (Overhead Shield) | $10.00 |
Harness Strap | $5.00 |
Harness Strap (Overhead Shield) | $5.00 |
Buckle, Crotch Strap and Tongues | $10.00 |
$5.00 | |
Locking Clip (All models) | $5.00 |
LATCH Belt | $20.00 |
Tether System | $10.00 |
Overhead Shield | FREE |
Seat Pad | FREE |
Headrest Foam & | FREE |
Instruction Manual (All models) | FREE |
Shipping
&handling*: $5.00 Sales tax**:
Total:
*$15.00 outside the continental U.S.
**CA 7.25%, IL 6.25%, IN 5%, NY 8.25%, OH 5.75%, PA 6%, SC 5%
MAIL ORDER TO: 
CENTURY PRODUCTS
P.O. BOX 100
ELVERSON, PA
ATTN: CUSTOMER SERVICE DEPARTMENT
OR FAX ORDER TO:
(610)
37
