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Palmcorder Accessory Order Form
Please photocopy this form when placing an order.
1. Palmcorder Mode! #
2. ltems Ordered
Subtotal
Your State & Local Sales Tax
Shipping & Handling |
5.00
Total Enclosed Lo
3. Method of payment (check one)
LU
Check or Money Order enclosed (NO C.O.D.SHIPMENTS)
O
VISA
Credit Card #
O
MasterCard
Expiration Date
O
Discover
Customer Signature
Make Check or Money Order to: MATSUSHITA ACCESSORIES
(Please do not send cash)
4. Shipping information (UPS delivery requires complete street address)
Ship To:
Mr.
Mrs.
Ms.
¿ _A_
A
First
Last
Phone #:
Day
{
)
Street Address
Night
{
)
City
State
Zip
TO OBTAIN ANY OF OUR OMNIMOVIE/PALMCORDER ACCESSORIES YOU CAN DO ANY OF
THE FOLLOWING:
VISIT YOUR LOCAL PANASONIC DEALER
OR
CALL PANASONIC'S ACCESSORY ORDER LINE AT 1-800-211-7262
[9 AM-9 PM M-F,
9 AM-7 AM
SAT-SUN, EST]
OR
MAIL THIS ORDER TO: PANASONIC SERVICES COMPANY
ACCESSORY
ORDER OFFICE
20421 84th Avenue South Kent, WA. 98032
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