Model No.
(Both numbers required)
Seat pad
Canopy
Canopy bow
3-point harness
5-point harness
Harness clip
Locking clip
Head support
Adjustable base
Subtotal:
Shipping
& handling*:
6% sales tax
(PA only):
Total:
*$15.00 outside the continental U.S.
P.O. BOX 100, MAIN STREET, ELVERSON, PA 19520-9974
Serial No.
Charge to credit card:
Visa
MasterCard
Discover
Check enclosed (payable to Graco Children's Products Inc.)
SHIP TO:
Name
Address
$5.00
City, State, Zip
(
Telephone
Return the form above with payment to:
GRACO CHILDREN'S PRODUCTS INC.
CUSTOMER SERVICE DEPARTMENT
Account #:
Expiration date:
Signature:
)