ORDER FORM

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1. Phone Orders To :
International To:
2. Fax Orders To :
3. Mail Orders To :
 
 
1-800-428-0440
1-CompanyPhone
1-CompanyFAX
Aritronix Ltd.
companyaddress1
companyaddress2

Ship To:
Name_______________________________________________________________________________
 
Address_____________________________________________________________________________
 
City________________________________State _______________Zip _________________________
 
Phone_________________________Type of Motorcycle _____________________________________
Part # Description Unit Price Total Price
TP-300 Motocycle Paging Security System 299.00  
Parts And Accessories
RID-3 Anti-Hijack And Light Flash Upgrade Kit 39.00
PS-6 High Power 6 Tone Siren 18.00
TRS-33 Additional Remote Transmitter 29.00
TPR-1 Additional Pager Receiver 59.00
Method of Payment
|__| Check Enclosed
|__| C.O.D. Cash / Money Order
|__| Charge My Credit Card
Subtotal
Shipping And Handling 12.00
Tax 5.5% (OH Residents)
Total
Card # |__|__|__|__| |__|__|__|__| |__|__|__|__| |__|__|__|__| Exp. Date |__|__| |__|__|
 
Signature _____________________________________