COMBI International Corporation • 199 Easy St. • Carol Stream, IL 60188 • www.combi-intl.com
Customer Service 1-800-992-6624 • 10:00 a.m. - 5:00 p.m. Central Time • Monday - Friday
Parts Order Form
If you would like to place an order for the following parts, please fill out the form below and return it to the following address:
COMBI International Corporation
or
Fax this completed form to us at
Attn: Customer Service Department
199 Easy Street
Carol Stream, IL 60188
IMPORTANT:
We must have this information to process your order:
Model Number:
9790-0
Parts List
for the Activity Rocker
™
Pedestal Model 9790-0
Price
Quantity
Total
1. Stay Bar
$ 5.00
2. Pedestal Arm
5.00
3. Pedestal Leg
5.00
4. Basket
15.00
5.
6.
7.
8.
9.
Amount of Order
Sales Tax (7.25%)
(IL residents only)
Total
If you need to order other parts for your stroller, please call us
toll-free at 1-800-992-6624.
Shipping and Handling Fees: Add $5.00 for orders $34.99 and
under.Add $10.00 for orders $35.00 and over. Note: Additional ship-
ping charges will apply outside of the Continental U.S.
Ship To:
Customer Name
Street Address
Street Address
City, State, Zip
Telephone Number
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Charge to my credit card:
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VISA
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MASTERCARD
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AMERICAN EXPRESS
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DISCOVER
Card Number
Expiration Date
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Cardholder’s Signature
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Check enclosed
9/5/2003
630-871-0606
Activity Rocker
™
Pedestal
9790 Series
