Camcorder Accessory Order Form (For U.s.a. Customers) - Panasonic Palmcorder PV-GS59 Operating Instructions Manual

Camcorder Accessory Order Form (For U.S.A. customers)

Please photocopy this form when placing an order.
1. Camcorder Model #
2. Items Ordered
Accessory #
3. Method of payment (check one)
Check of 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 CAMCORDER ACCESSORIES YOU CAN DO ANY OF THE
MAIL THIS ORDER TO: PANASONIC SERVICES COMPANY ACCESSORY ORDER OFFICE
82
Description
Credit Card #
Expiration Date
Customer Signature
Make Check or Money Order to: PANASONIC ACCESSORIES
Last
VISIT YOUR LOCAL PANASONIC DEALER
CALL PANASONIC' S ACCESSORY ORDER LINE AT 1-800-332-5368
[6 AM-5 PM M-F, 6 AM-10:30 AM SAT, PACIFIC TIME]
20421 84th Avenue South Kent, WA. 98032
Price Each
Your State & Local Sales Tax
Shipping & Handling
State Zip
FOLLOWING:
OR
OR
Quantity
Subtotal
Total Enclosed
Phone #:
Day ( )
Night ( )
Total Price
6.95