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ORDER FORM FOR 3 BUTTON TRANSMITTER
MODEL NO. APS 95 BT3
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 : ___________________________________________________
Address : _________________________________________________
City : __________________ State : _______ Zip Code : ___________
2. Telephone Number : ( _______ ) _______________________________
3. Enter the total number of transmitters required here : _______________
4. The cost per transmitter is $ 65.00.
5. Enter the total amount enclosed here : ___________________________
( New York state residents must include the appropriate sales tax. )
6. Method of payment; check one of the boxes below.
! Mastercard ! Visa ! Check or money order * ( do not send cash )
* Make checks payable to Audiovox Corporation
7. Credit Card Number : ________________________________________
8. Credit Card Expiration Date : _____________________
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.
9. Mail this form, and your check, to ;
Audiovox Corporation
150 Marcus Blvd.
Hauppauge, N.Y., 11788
Attn: TRANSMITTER DEPARTMENT
128-4619
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Form No. 128-4619