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68 Chapter 5
Other Information
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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
My card expires:
My card
expires:
Copy Number
above your
name on
MasterCard
AUTHORIZED SIGNATURE
(Credit card order will not be processed without signature)
Print or type your name and
address clearly.
A complete and correct
order will save you days
of waiting.
IMPORTANT: Copy complete account number
from your Discover Card
My card expires:
To Place an 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 on 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
Name: _________________________________________
Street: _________________________________________
Apt. ___________________________________________
City: __________________________________________
State: _________________________Zip: _____________
Daytime Telephone No.: ___________________________
Please make sure that both sides of this form have been
filled out completely.
• Allow 4-6 weeks for delivery.
• All accessories are subject to availability.
• Prices are subject to change.