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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.
Grey Button Pad order A1BTX2Pr
Blue Button Pad orderA1BTX2P
1)Name:_____________________________________________
2) Address:__________________________________________
3) City:________________State:________Zip Code:__________
4 Telephone Number:( )_____________________
5) Total Number Of Transmitters Required:_______
Cost Per Transmitter is: $85.00
Multiply By Number Of Transmitters X
6) Enter TotalAmount Enclosed _______
(New York State Residents must include the appropriate sales tax)
7) Method of Payment:
Mastercard Visa CheckorMoney Order (donotsend cash)
Make Checks Payable To Audiovox Corporation
Credit Card Number:____________________________________
Credit Card Expiration Date: ____/___/____
8) Mail this form along with your payment to:
Transmitter Ordering Department
Audiovox Corporation 150 Marcus Blvd., Hauppauge N.Y.
11788
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
ORDERFORMFOR TRANSCEIVER A1BTX2
© 2007 Audiovox Electronics Corp., Hauppauge, N.Y. 11788 128-8116
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