Whistler 1570 Manual page 30

ACCESSORY ORDER FORM
PLEASE SHIP TO:
Name ___________________________________________
Street __________________________________________
City __________________ State _____ Zip _________
Telephone Number ( ______ ) ______________________
Order Code/Description Quantity Total Price
Subtotal
Sales Tax (if Applicable)
Shipping and Handling
Total Enclosed
SEND ORDER FORM WITH CERTIFIED CHECK OR
MONEY ORDER TO:
IF PAYING BY MASTERCARD OR VISA PLEASE PROVIDE:
Type Of Card
Name On Card ___________________________________
Card Number ____________________________________
Expiration Date __________________________________
Cardholder's Signature ____________________________
Whistler CTS
16 Elizabeth Drive
Chelmsford, MA 01824
_____ MasterCard
29
$
$ 3.00
$
_____VISA