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Accessory order form – RCA Satellite TV Antenna User Manual

Page 4

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DESCRIPTION

PART NO.

PRICE

QTY.

TOTAL

2nd Room Kit

D940EXP

99.95

Chimney Mount

D915

22.95

Amplified Antenna

ANT200

49.95

Wireless Phone Jack System

D916

79.95

In-Line Amplifier

D903

24.95

Remote Control Signal Sender

D940

59.95

Remote Control Signal Sender
Extension Unit

D935

39.95

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

5.00

TOTAL AMOUNT ENCLOSED

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.

1-800-338-0376

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.

Video Accessories

P.O. Box 8419

Ronks, PA 17573

PRICES SUBJECT TO CHANGE WITHOUT NOTICE

Please Allow 4 - 6 Weeks For Delivery

Use VISA, MasterCard or Discover Card. Money Order or check must be in U.S currency only. No
COD or cash.

Name: ___________________________________________________________________________________

Address: _________________________________________________________________________________

City: ___________________________________

Zip Code: _____________________________________

❑ Visa ❑ MasterCard ❑ Discover

Credit Card Number: _______________________________

Expiration Date: ____________________

Signature: (Required for Credit Card Orders) _______________________________________________

Detach Her

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