Hollywood Series 4000 ORDER FORM

Use your credit card or send a check or money order for $495 to Radio Mall, 2412 Unity Ave. N., Dept. HOLW, Minneapolis, MN, 55422, USA. MN residents, please add sales tax. All payments must be in U.S. funds.  Price includes free shipping worldwide.

Name_________________________________________ Company ___________________________________

Street Address______________________________________________________________________________

City, State, Zip___________________________________________ Country___________________________

Phone________________________ FAX________________________ E-Mail__________________________

____VISA ____ MasterCard ____ American Express/Optima ____Discover 

Card#_____________________________ Exp.Date______Signature______________________ CCID_____

For credit card orders, phone or FAX 763-522-6256

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