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Palmcorder Accessory Order Form
' I
Please photocopy this form when placing an order.
1. Palmcorder Model #
2. Items Ordered
Accessory # Description Price Each Quantity
Total Price
Subtotal
Your State & Local Sales Tax
Shipping& Handling 6.95
Total Enclosed
3. Method of payment (check one)
[] Check or Money Order enclosed (NO C.O.D,SHIPMENTS)
[] VISA Credit Card #
[] MasterCard Expiration Date
[] Discover Customer Signature
Make Check or Money Order to: PANASONIC ACCESSORIES
(Please do not send cash)
4. Shipping information (UPS delivery requires complete street address
ShipTo:
Mr.
Mrs.
Ms.
First Last
StreetAddress
City State Zip
Phone#:
Day (
Nighl (
TO OBTAIN ANY OF OUR PALMCORDER ACCESSORIES YOU CAN DO ANY OF THE
FOLLOWING:
VISIT YOUR LOCAL PANASONIC DEALER
OR
CALL PANASONIC'S ACCESSORY ORDER LINE AT 1-800-332-5368
[6 AM-5 PM M-F, 6 AM-10:30 AM SAT, PACIFIC TIME]
OR
MAIL THIS ORDER TO: PANASONIC SERVICES COMPANY ACCESSORY
ORDER OFFICE
20421 84th Avenue South Kent, WA. 98032
37
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