Accessory Order Form

To Order

To place your order by phone, have your Visa, MasterCard or Discover Card ready and call the toll- free number listed below.

Use this number only to place an order for accessory items listed on this order form.

1-800-338-0376

To place your order by mail, detach and mail the completed order form with credit card information, money order or check in US currency (made payable to Thomson multimedia Inc.) to the following address:

Here

Thomson Inc.

Mail Order Department

PO Box 8419

Ronks, PA 17573-8419

 

Charge your order on your VISA,

 

 

 

 

 

MasterCard, or Discover Card by

 

 

 

 

 

filling in below

 

 

 

 

USE YOUR CREDIT CARD

 

 

 

 

 

 

 

 

®

 

IMPORTANT: Copy complete account number

 

 

 

 

 

from your VISA card

 

 

 

 

 

My card expires:

 

 

 

 

IMPORTANT: Copy complete account number

s

r

r

TM

 

 

 

 

 

from your MasterCard

 

 

 

 

Copy Number

My card

 

 

 

 

above your

expires:

 

 

 

 

name on

 

 

 

 

 

MasterCard

 

 

 

 

 

IMPORTANT: Copy complete account number

 

 

 

 

 

from your Discover Card

 

 

 

 

 

My card expires:

 

 

 

 

 

AUTHORIZED SIGNATURE

 

 

 

 

(Credit card order will not be processed without signature)

Print or type your name and

A complete and correct

address clearly.

order will save you days

 

of waiting.

Name:

Street:

Apt:

City:

State:Zip:

Daytime phone number:

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.

AC power converter

Headset

5-2495

 

5-2425

Description

Part No.

Price

Qty Total

AC power converter

5-2495

$20.85

 

Headset

5-2425

$19.95

 

Prices are subject to change without notice.

 

 

Total Merchandise

$

_______

Sales Tax

$

_______

We are required by law to collect the appropriate

 

sales tax for each individual state, county, and

 

locality to which the merchandise is being sent.

 

Shipping and Handling

$

5.00

Total Amount Enclosed

$

_______

Use VISA, MasterCard, or Discover Card preferably.

 

Money order or check must be in U.S. currency only.

 

No COD or CASH.

 

 

 

All accessories are subject to availability.

Where applicable, we will ship a superseding model.

Detach

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RCA 25202 manual Accessory Order Form, To Order