ORDER FORM FOR APS99BT3BCF4 & APS99BT3SBCF4
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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. Please indicate
which button pad is used with your transmitter as indicated above. __________
Please indicate transmitter model number as found on back of case. ________
1. Name : ______________________________________________________
Address : _____________________________________________________
City : ___________________ State : ________ Zip Code : ______________
2. Telephone Number : (__________) ________________________________
3. Enter the total number of transmitters required here : ____________________
4. The cost per transmitter is $ 65.00.
5. Enter the total amount enclosed here : _______________________________
( New York state residents must include the appropriate sales tax. )
6. Method of payment; check one of the boxes below.
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Mastercard
Visa
* Make checks payable to Audiovox Corporation
7. Credit Card Number : ___________________________________________
8. Credit Card Expiration Date : __________________________
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.
9. Mail this form, and your check, to ;
Audiovox Electronics Corp., 150 Marcus Blvd., Hauppauge, NY 11788
Attn.: TRANSMITTER DEPARTMENT
© 2003 Audiovox Electronics Corp., 150 Marcus Blvd., Hauppauge, NY 11788
TRANSMITTER
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Check or money order * (do not send cash)
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