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Palmcorder Accessory Order Form
Please photocopy this form when placing an order.
1. Palmcorder Model #
2. Items Ordered
Accessory #
3. Method of payment (check one)
Check of Money Order enclosed (NO C.O.D.SHIPMENTS)
VISA
MasterCard
Discover
(Please do not send cash)
4. Shipping information (UPS delivery requires complete street address)
Ship To:
Mr.
Mrs.
Ms.
First
Street Address
City
TO OBTAIN ANY OF OUR PALMCORDER ACCESSORIES YOU CAN DO ANY OF
CALL PANASONIC'S ACCESSORY ORDER LINE AT 1-800-332-5368
MAIL THIS ORDER TO: PANASONIC SERVICES COMPANY ACCESSORY ORDER OFFICE
In CANADA, please contact your local Panasonic dealer for more information on Accessories.
Description
P rice Each
Credit Card #
Expiration Date
Customer Signature
Make Check or Money Order to: PANASONIC ACCESSORIES
Last
State
THE FOLLOWING:
VISIT YOUR LOCAL PANASONIC DEALER
[6 AM-5 PM M-F, 6 AM-10:30 AM SAT, PACIFIC TIME]
20421 84th Avenue South Kent, WA. 98032
(For USA Customers)
Quantity
Your State & Local Sales Tax
Shipping & Handling
Total Enclosed
Phone#:
Day
Night
Zip
OR
OR
101
Total Price
Subtotal
6.95
(
)
(
)
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