
Reference
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.
United States and Canada Orders
To place your order by phone, have your Visa, MasterCard or Discover Card ready and call the toll- free number listed below between 8 AM and 10 PM (EST) Monday through Friday or between 9 AM and 5 PM (EST) Saturday.
Use this number only to place on order for accessory items listed on this order form.
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 Consumer Electronics, Inc.) to the following address:
Video Accessories
PO Box 8419
Ronks, PA 17573
90