Model No.
(Both Numbers Required)
SHIP TO:
Name
Address
City, State, Zip Code
Telephone (including Area Code)
E-mail Address
Fabric Seat Pad (All Models) ....................................$35.00
Fabric Shield Pad (Overhead Shield) ........................$10.00
Harness Strap (5-Point) ............................................$5.00
Harness Strap (Overhead Shield)................................$5.00
Buckle, Crotch Strap and Tongues (5-Point)............$10.00
2-Piece Harness Tie (All models) ................................$5.00
Locking Clip (All models) ..........................................$5.00
LATCH Belt ............................................................$20.00
Tether System ........................................................$10.00
Overhead Shield 2-Button Retainer Clip ....................FREE
Seat Pad 2-Button Retainer Clip (All models) ..............FREE
Headrest Foam & Push-In Buttons (All models) ..........FREE
Instruction Manual (All models) ..................................FREE
Serial No.
Check or money order enclosed
(payable to Century Products)
Charge to credit card
Visa
MasterCard
Account #
Expiration date
Signature
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:
CENTURY PRODUCTS
150 Oaklands Blvd.
Exton, PA 19341
ATTN: CUSTOMER SERVICE DEPARTMENT
OR FAX ORDER TO:
610-884-8730
$5.00
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