Name: First _____________________ Last ______________________________
Address: _________________________________________________________
City: _______________________________________ State: ____________
Zip: ________________ Phone # : __________________________________
E-mail : ______________________________________________________
Type of payment : Check ______ Money Order _____ Credit Card _______
Visa___Mastercard___ Signature __________________________________
Credit Card # __ __ __ __
- __ __ __ __ - __ __ __ __ - __ __ __ __
Expiration Date __ __ / __ __
Quantity : "BCR"_________ x $24.95ea. ______________ Subtotal
Quantity : "BCR 2"_________x $19.95ea_____________Subtotal
Charging Circuit(s) _______ x $19.95ea.______________ Subtotal(Req'd for Lionel only)
Reprogam Engine__________x$25.00 ______________Subtoal
Proto Sound 2 upgrade_____x$250.00_______________Subtotal
Free BCR total___________
$5.00 Shipping
Pa. Resident add 6% sales tax _________________
_____________________Total
To order by check, money
order, or credit card
print this page and mail
it with your payment to :
J and W Electronics
427 Sarah Woods Dr.
Red Lion, Pa 17356
or by credit card only, print this page and fax to 717 417 2820
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to J and W Electronics