Model No.
(Both Numbers Required)
SHIP TO:
Name
Address
City, State, Zip Code
Telephone (including Area Code)
E-mail address
Check or money order enclosed
(payable to Graco Children's Products Inc.)
Charge to credit card
Visa
MasterCard
Account #
Expiration date
Signature
Serial No.
Discover
Subtotal:
Shipping
& handling*:
Sales tax**:
Total:
* $15.00 outside the
continental U.S.
**CA 7.25%, IL 6.25%, IN 5%,
NY 8.25%, OH 5.75%, PA 6%,
SC 5%
MAIL ORDER TO:
GRACO CHILDREN'S PRODUCTS, INC.
P.O. BOX 100
ELVERSON, PA 19520-9974
ATTENTION: CUSTOMER SERVICE
DEPARTMENT
OR
FAX ORDER TO:
(610)286-4555
$5.00
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