Model No. | Serial No. |
(Both Numbers Required)
SHIP TO:
Name
Address
City, State, Zip Code
Telephone (including Area Code)
Subtotal:
Shipping | $5.00 |
& handling*: |
Sales tax**:
Total:
*$15.00 outside the continental U.S.
**CA 6%, IL 6.25%, IN 5%, NY 8.25%, OH 5.75%, PA 6%, SC 5%
Seat pad | Check or money order enclosed |
| |
Canopy | (payable to Graco Children’s Products Inc.) | ||
Canopy bow | Charge to credit card |
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Visa | MasterCard | Discover | |
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Harness clip |
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Account # |
|
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Locking clip |
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Head support |
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Expiration date | ||
Base | ||
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| Signature |
Return the form with payment to:
Graco Children’s Products Inc.
Customer Service Department
P.O. Box 100, Main Street
Elverson, PA 19520
41
