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.
1) Name:___________________________________________
2) Address:_________________________________________
3) City:________________State:________Zip Code:__________
4 Telephone Number:(
)_____________________
5) Total Number Of Transmitters Required:_______
Cost Per Transmitter is:
$85.00
Multiply By Number Of Transmitters X
6) Enter Total Amount Enclosed _______
(New York State Residents must include the appropriate sales tax)
7) 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: ____/___/____
8) Mail this form along with your payment to:
Transmitter Ordering Department
Audiovox Corporation 150 Marcus Blvd., Hauppauge N.Y. 11788
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
6
ORDER FORM FOR TRANSMITTER 5BCR
128-6386
