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Subtotal:
Shipping
& handling*: $5.00
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%
Model No.
(Required)
Left arm pad
Right arm pad
Head and lower back support
Back support pad
Head support pad
Base pad
Base assembly (without pad)
Shoulder belt positioning clip
Instruction booklet
Check or money order enclosed
(payable to Graco Children’s Products Inc.)
Charge to credit card
Visa MasterCard Discover
Account #
Expiration date
Signature
37
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