Audiovox Auto Security 5BCR Program Manual page 7

ORDER FORM FOR TRANSCEIVERS 5BCR & 5BCR03
5BCR/5BCR03
Attention: Transmitter Ordering Department
Important: To help us expedite your order, please print all of the information
legibly and mail this form and your payment according to the instructions
below.
Be certain to specify MODEL NUMBER found on back of your transceiver___________
1) Name:___________________________________________
2) Address:_________________________________________
3) City:________________State:________Zip Code:__________
4 Telephone Number:(
5) Total Number Of Transmitters Required:_______
Cost Per Transmitter is:
Multiply By Number Of Transmitters
6) Enter Total Amount Enclosed
(New York State Residents must include the appropriate sales tax)
7) Method of Payment:
Mastercard Visa
Make Checks Payable To Audiovox Corporation
Credit Card Number:___________________________________
Credit Card Expiration Date:
8) Mail this form along with your payment to:
Transmitter Ordering Department
Audiovox Corporation 150 Marcus Blvd., Hauppauge N.Y. 11788
Credit card purchasers can order additional or replacement
transmitters by phone. Simply dial 1 - 800 - 645 - 4994, and follow
the instructions from the operator interface
5BCR05
)_____________________
$85.00
X
_______
Check or Money Order (do not send cash)
____/___/____
7
128-6799A
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