www.panafonic.com
Secure Order, click here
ON-LINE  SHOPPING ORDER "traditional"

I have read the Sales Conditions, & I want to place an order, Please contact me as soon as possible & also send me a Proforma Invoice. The completion of the following form does not obligate me to buy the product.

Personal Details
Full Name: (Or Company Name)
Address:
City: 
Zip:
State:
Country: 
Contact Person:
TEL: please include your country code, except US
FAX:
E-Mail:
Ship the Order to

If the details of the consignee are same as above, you need not fill up this section.

SEND TO: (Full Name)  
 Send as a GIFT, don´t include billing information, send Invoice to the above address.
Address:
Attention Mr/Miss:
City:
Zip:
State:
Country: 
TEL:
FAX:
E-Mail:
I wish to pay by

VISA or MasterCard  AMERICAN EXPRESS (Sorry, No other Mode of Payment is accepted)

Card Number: Expires: monthyear
CVV2 Number:
Please include this number if available on your card otherwise leave blank		 Visa / Mastercard users
On the back of the card, in the signature area, is your credit card number followed by the 3 digit CVV2 number. Or may be just 4 digits followed by the 3 digit CVV2 number.
American Express users
The 4 digit CVV2 number is printed above and to the right of your credit card number on the front of the card.
CardHolder´s Name:
I prefer to send the Credit Card Info by E-Mail or Fax . see Contact Page
"ORDER"

To avoid misunderstadings, Please specify  the Reference number of the Product exactly as it apperas in our Catalogue (see the bottom of this page)

Reference

Pcs.

SHIPPING

 Select the Shipping mode you prefer:
Shipping Charges
Zone Ship the order via
European Orders:-
Ordinary Mail  (4-6 days delivery)
Courrier  (1-2 days delivery)
USA & Canada Orders:-
Ordinary Mail  (7-8 days delivery)
Courrier  (1-2 days delivery)
Rest of the World Orders:-
Ordinary Mail  (7-15 days delivery)
Courrier  (2-4 days delivery)

Comments

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Revised: 10-06-03.