Manual
Charge your order on your VISA,
MasterCard, or Discover Card by
filling in below
USE YOUR CREDIT CARD
IMPORTANT: Copy complete account number
from your VISA card
VISA
Mycordoxpiro :I--FII--F1
IMPORTANT: Copy complete account number
from your MasterCard
r--vvr-1 r--vv1--1r--vvr-1 r--vvr-1
Copy Number
above your
name on
MasterCard
My card [--[--] [--[--]
expires:
IMPORTANT: Copy complete account number
l¥om your Discover Card
r--vvr-1 r--vv1--1r--vvr-1 r--vvr-1
My card expires: [-'T-] l--T-]
AUTHORIZED SIGNATURE
(Credit card order will not be processed without signature)
Print or type your name and
address clearly.
A complete and correct
order will save you days
of waiting.
12
Name:
Street:
Apt:
City:
State:
Phone Number:
Zip:
Please make sure that both sides of this fbrm
have been filled out completely.
• Allow 4 weeks for delivery.
• All accessories are subject to availability.
• Prices are subject to change
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Placing An Order
To place your order by phone, have your Visa, MasterCard or
Discover Card ready and call the toll-free number listed below.
Use this number only to place an order for accessory items
listed on this order form.
1-800-338-0376
To place your order by mail, detach and mail the completed
order form with credit card information, money order or check
in US currency (made payable to Thomson Consumer
Electronics, Inc.) to the following address:
Video Accessories
PO Box 8419
Ronks, PA 17573










