Accessory Order Form - RCA Satellite TV Antenna Installer's Manual

Accessory Order Form

To order accessories, contact your local Dealer. If a dealer is not nearby, you can also follow the
directions below to order by telephone or by direct mail.
To place your order by phone, have your VISA, MasterCard or Discover Card ready and call the toll-
free number listed below between 8:00 am and 10:00 pm (EST), Monday thru Friday, or 9:00 am
and 5:00 pm (EST), Saturday. USE THIS number only to place an order for the accessories listed on
this order form.
To place an order by mail, detach and mail the completed order form with credit card information,
check or money order (in U.S currency), made payable to Thomson Consumer Electronics, Inc., to
the following address.
DESCRIPTION
2nd Room Kit
Chimney Mount
Amplified Antenna
Wireless Phone Jack System
In-Line Amplifier
Remote Control Signal Sender
Remote Control Signal Sender
Extension Unit
TOTAL MERCHANDISE
SALES TAX
We are required by law to collect the appropriate sales tax for each individual
state, country, and locality to which the merchandise is being sent.
SHIPPING AND HANDLING
TOTAL AMOUNT ENCLOSED
Use VISA, MasterCard or Discover Card. Money Order or check must be in U.S currency only. No
COD or cash.
Name: ___________________________________________________________________________________
Address: _________________________________________________________________________________
City: ___________________________________
Visa MasterCard
Credit Card Number: _______________________________
Signature: (Required for Credit Card Orders) _______________________________________________
1-800-338-0376
Video Accessories
P.O. Box 8419
Ronks, PA 17573
PART NO.
D940EXP
D915
ANT200
D916
D903
D940
D935
PRICES SUBJECT TO CHANGE WITHOUT NOTICE
Please Allow 4 - 6 Weeks For Delivery
Zip Code: _____________________________________
Discover
PRICE QTY.
99.95
22.95
49.95
79.95
24.95
59.95
39.95
Expiration Date:____________________
TOTAL
5.00