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50 Chapter 4
Other Information
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
IMPORTANT:
Copy complete account number from your MasterCard
Expiration date:
Expiration date:
Copy Number above your
name on MasterCard
AUTHORIZED SIGNATURE
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.
IMPORTANT:
Copy complete account number from your Discover Card
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:
Expiration date:
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:
Video Accessories
PO Box 8419
Ronks, PA 17573
✂
Detach Here