Palmcorder Accessory Order Form - Panasonic Palmcorder PalmSight PV-L591 Operating Instructions Manual

Palmcorder Accessory Order Form

Please photocopy this form when placing an order.
1. Palmcorder Model #
2. Items Ordered
Accessory #
3. Method of payment (check one)
Check or Money Order enclosed (NO C.O.D.SHIPMENTS)
VISA
MasterCard
Discover
(Please do not send cash)
4. Shipping information (UPS delivery requires complete street address)
Ship To:
Mr.
Mrs.
Ms.
First
Street Address
City
TO OBTAIN ANY OF OUR PALMCORDER ACCESSORIES YOU CAN DO ANY OF THE
CALL PANASONIC'S ACCESSORY ORDER LINE AT 1-800-332-5368
MAIL THIS ORDER TO: PANASONIC SERVICES COMPANY ACCESSORY
36
For assistance, please call : 1-800-211-PANA(7262) or send e-mail to : consumerproducts@panasonic.com
Description
Credit Card #
Expiration Date
Customer Signature
Make Check or Money Order to: PANASONIC ACCESSORIES
Last
State
FOLLOWING:
VISIT YOUR LOCAL PANASONIC DEALER
[6 AM-5 PM M-F, 6 AM-10:30 AM SAT, PACIFIC TIME]
ORDER OFFICE
20421 84th Avenue South Kent, WA. 98032
Price Each
Your State & Local Sales Tax
Shipping & Handling
Total Enclosed
Zip
OR
OR
Quantity
Total Price
Subtotal
Phone #:
Day ( )
Night ( )
6.95