Charge your order on your VISA,MasterCard,
or Discover Card by filling in below
USE YOUR CREDIT CARD
IMPORTANT: Copy complete account number from your VISA card [I/l__ i]
[--]""]"_ _ ['-X_ _ Expiration date: I--_
IMPORTANT: Copy complete account number from your MasterCard
I1 I I II I I I I[--I--]---N[-I-]---N
Copy Number above your name on MasterCard _ Expiration date: I I II I I
IMPORTANT: Copy complete account number from your Discover Card
I I I I II I I I II I I I II I I I I
Expiration date: _ [-'W'-]
AUTHORIZED SIGNATURE
Prices are subject to change without notice.
Print or type your name and
address clearly.
Name:
Street:
City:
State:
A complete and correct order will
save you days of waiting.
Apt:
Zip:
> • , J •
Please make sure that both sides of this form have been filled out completely.
• Allow 4 weeks for delivery.
• All accessories are subject to availability.
€3
, ?
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