Reference

Charge your order on your VISA, MasterCard, or Discover Card by filling in below

USE YOUR CREDIT CARD

®

IMPORTANT: Copy complete account number from your VISA card

My card expires:

IMPORTANT: Copy complete account number

 

 

 

s

r r TM

 

 

 

 

 

 

 

 

 

 

 

 

 

from your MasterCard

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Copy Number

 

 

 

 

My card

above your

 

 

 

 

expires:

 

 

 

 

name on

 

 

 

 

MasterCard

 

 

 

 

IMPORTANT: Copy complete account number from your Discover Card

My card expires:

AUTHORIZED SIGNATURE

(Credit card order will not be processed without signature)

Print or type your name and

A complete and correct

address clearly.

order will save you days

 

of waiting.

Name: _____________________________________________

Street: _____________________________________________

________________________ Apt. ___________________

City: ______________________________________________

State: ___________________ Zip: ___________________

Daytime Telephone No.: _____________________________

Please make sure that both sides of this form have been filled out completely.

Allow 4 weeks for delivery.

All accessories are subject to availability.

Prices are subject to change.

To Place an Order:

To place your order by phone, have your Visa, MasterCard or Discover Card ready and call the toll-free number listed below.

Use this number only to place an order for accessory items listed on this order form.

1-800-338-0376

To place your order by mail, detach and mail the completed order form with credit card information, money order or check in US currency (made payable to Thomson multimedia Inc.) to the following address:

Video Accessories

PO Box 8419

Ronks, PA 17573

60 _______________________________________________________________ chapter 6