17
LACOSTE WATCHES SERVICE REQUEST FORM A
Name _________________________________________________
Address ________________________________________________
City __________________________________________________
State/Province ___________ Country ___________ ZIP/Postal Code ___________
E-mail _______________________ Phone (_____)_________________
Watch Model _____________________________________________
What needs service, replacement or repair: _______________________________
____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
___________________________________________________
____________________________________________________
__________________________________________
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LACOSTE WATCHES US/CANADA SERVICE REQUEST FORM B
Include with all service requests sent to LACW Service Centers in the U.S. or Canada
ITEM
PRICE
TOTAL
Battery
$35.00
USD/
$35.00
CAD
$__________
Shipping
$15.00 USD/
$15.00 USD or
&
Handling
$15.00
CAD
$15.00
CAD
TOTAL:
$_________
Payment method:
___ Check or Money Order
___ MasterCard
___ Visa
Account number: ________________________________
Expiration date: _________________________________
Signature: _____________________________________
(Required for credit card purchases)
OBTAINING SERVICE