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:
q
Mastercard
q
Visa
q
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-2K4
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.
Note: Transmitter model number found on back of case. ___________
(
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.
128-5754A
© 2000 Audiovox Electronics Corp., Hauppauge, NY, 11788
