Model No. |
| Serial No. |
| Account #: |
(Both numbers required)
Seat pad Canopy) Canopy bow
Charge to credit card:
Visa
MasterCard
Discover
Expiration date:
Signature:
Harness clip Locking clip Head support Adjustable base
Check enclosed (payable to Graco Children’s Products Inc.)
SHIP TO:
Total: |
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| Name |
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Shipping |
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& handling: |
| $5.00 Address |
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6% sales tax |
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(PA only): |
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| City, State, Zip | ||||
Total amount |
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due: |
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| Telephone |
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Return the form above with payment to:
GRACO CHILDREN’S PRODUCTS INC.
CUSTOMER SERVICE DEPARTMENT
P.O. BOX 100, MAIN STREET, ELVERSON, PA
