Palmcorder Accessory Order Form
Please photocopy this form when placing an order.
1.Palmcorder Model #
2.Items Ordered
Accessory # | Description | Price Each | Quantity | Total Price |
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| Subtotal |
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| Your State & Local Sales Tax |
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| Shipping & Handling | 6.95 |
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| Total Enclosed |
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3. Method of payment (check one) |
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| Check or Money Order enclosed (NO C.O.D.SHIPMENTS) |
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| VISA | Credit Card # |
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| MasterCard | Expiration Date |
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| Discover | Customer Signature |
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| Make Check or Money Order to: PANASONIC ACCESSORIES | |||||||||||
(Please do not send cash) |
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4. Shipping information (UPS delivery requires complete street address) |
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Ship To: |
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Mr. |
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Mrs. |
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Ms. |
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| First | Last |
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| Day | ( |
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| Street Address |
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| Night | ( |
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| City |
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TO OBTAIN ANY OF OUR PALMCORDER ACCESSORIES YOU CAN DO ANY OF THE
FOLLOWING:
VISIT YOUR LOCAL PANASONIC DEALER
OR
CALL PANASONIC’S ACCESSORY ORDER LINE AT
[6
OR
MAIL THIS ORDER TO: PANASONIC SERVICES COMPANY ACCESSORY
ORDER OFFICE
20421 84th Avenue South Kent, WA. 98032
38
For assistance, please call :
