Reference |
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| Charge your order on your VISA, |
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| To Place an Order: | |||
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| MasterCard, or Discover Card by |
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| To place your order by phone, have your Visa, | |||
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| filling in below |
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U S E | Y O U R | C R E D I T | C A R D | ® | MasterCard or Discover Card ready and call the | |||
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I M | P O R TCopyA NcompleteT : | account number |
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| from your VISA card |
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| Use this number only to place an order for | ||
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| accessory items listed on this order form. |
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| My card expires: |
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| To place your order by mail, detach and mail the |
I M | P O R TCopyA NcompleteT : | account number | s | r | r | completed order form with credit card information, | ||
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| money order or check in US currency (made | |||||
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| from your MasterCard |
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| payable to Thomson multimedia Inc.) to the |
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| following address: |
Copy Number |
| My card |
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| Video Accessories | ||
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| PO Box 8419 | ||||
above your |
| expires: |
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| name on |
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| Ronks, PA 17573 | |
MasterCard |
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I M | P O R TCopyA NcompleteT : | account number |
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| from your Discover Card |
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| My card expires: |
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| AUTHORIZED SIGNATURE |
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(Credit card order will not be processed without signature) |
Print or type your name and address clearly.
A complete and correct 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.
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