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www.midxtc.com
Accessories Order Form

Please send Money Order or ll in the Visa/Master Card information and

mail to the address below. Please DO NOT send cash or checks. Make

Money Order to Midland Radio Corporation.

Name:_________________________________________________________________________________________________
Address:_______________________________________________________________________________________________
City:__________________________________________________________________State:_________Zip Code:__________
Telephone:___________________________________________________________Email:____________________________
CC#_________________________________________________________________ Type:_________Exp:________________
QTY ITEM PRICE TOTAL
XTA101 $29.99
XTA102 $19.99
XTA103 $19.99
XTA104 $14.99
XTA105 $19.99
XTA106 $19.99
XTA107 $19.99
XTA108 $19.99
XTA301 $29.99
Mail To:
Midland Radio Corporation
Consumer Dept.
5900 Parretta Drive
Kansas City, MO 64120
______________________________
Or Call 816.241.8500
______________________________
To order online go to
www.midlandradio.com
Sub-total ____________________
Tax (MO, CO, IL, FL Only) ____________________
S&H $14.95_______________
(Applies to Domestic US only. For Hawaii, Alaska, and Puerto Rico S&H will be $38.25 for 1 lb
and $64.25 for 2lbs or more).
Total $____________________