Others
Camcorder
Accessory
Order Form (For USA Customers)
Please photocopy
this form when placing an order.
1. Palmcorder Model #
2. Items Ordered
Accessory #
Description
Price Each
Quantity
Total Price
3. Method of payment (check one)
[]
[]
[]
[]
Subtotal
Your State & Local Sales Tax
Shipping & Handling
Total Enclosed
6.95
Check of Money Order enclosed (NO C.O.D.SHIPMENTS)
VISA
Credit Card #
MasterCard
Expiration Date
Discover
Customer Signature
Make Check or Money Order Payable to: PANASONIC ACCESSORIES
(Please do not send cash)
4. Shipping information (UPS delivery requires complete street address)
Ship To:
Mr.
Mrs.
Ms.
First
Last
Phone#:
Day
(
Street Address
Night
(
City
State
Zip
TO OBTAIN ANY OF OUR PALMCORDER
ACCESSORIES
YOU CAN DO ANY OF
THE FOLLOWING:
VlSITYOUR
LOCAL PANASONIC
DEALER
OR
CALL PANASONIC'S
ACCESSORY ORDER LINE AT 1-800-332-5388
[6 AM-6 PM M-F, PACIFIC TIME]
OR
MAIL THIS ORDER TO: PANASONIC SERVICES COMPANY ACCESSORY
ORDER OFFICE
20421 84th Avenue South Kent, WA. 98032
In CANADA, please contact your local Panasonic dealer for more information on Accessories.
7.7
LSQT1121