Audiovox APS-2K4MS User Manual

Page 6

1) Pad Number: _____________________________________

2) Name: __________________________________________

3) Address: ________________________________________

4) City: ________________ State: _____ Zip Code: ________

5) Telephone Number: (_____) _______________
6) Total Number Of Transmitters Required:

Cost Per Transmitter is:

$65.00

Multiply By Number Of Transmitters X ______

7) Enter Total Amount Enclosed _________________

(New York State Residents must include the appropriate sales tax)

8) Method of Payment:

Mastercard

Visa

Check or Money Order (do not send cash)

Make Checks Payable To Audiovox Corporation

Credit Card Number: _________________________________

Credit Card Expiration Date: ____ / _____ / _____

9) Mail this form along with your payment to:

ORDER FORM FOR TRANSMITTER APS-2K4MS

Audiovox Electronics Corp., 150 Marcus Blvd., Hauppauge, N.Y., 11788

Attn.: TRANSMITTER DEPARTMENT

Attention:
Transmitter Ordering
Department
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.

Indicate the pad number of your transmitter selected from the
pads shown above.

(

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.

128-5965