Order Hearing Aid Batteries Offline from Buyer’s Haven

Please print out this form and mail to the address at the bottom of page with payment.

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Renata Hearing Aid Batteries

Code / Description /
Price
/ Quantity / Total
102-101-5001 / Single Package Size 10 (4 Batteries) / 2.44
102-101-5002 / Single Package Size 13 (4 Batteries) / 2.44
102-101-5003 / Single Package Size 312 (4 Batteries) / 2.44
102-101-5004 / Single Package Size 675 (4 Batteries) / 2.44
102-101-6001 / Three Packages Size 10 (12 Batteries) / 6.24
102-101-6002 / Three Packages Size 13 (12 Batteries) / 6.24
102-101-6003 / Three Packages Size 312 (12 Batteries) / 6.24
102-101-6004 / Three Packages Size 675 (12 Batteries) / 6.24
102-101-7001 / Ten Packages Size 10 (40 Batteries) / 17.24 / 1 / 17.29
102-101-7002 / Ten Packages Size 13 (40 Batteries) / 17.24
102-101-7003 / Ten Packages Size 312 (40 Batteries) / 17.24
102-101-7004 / Ten Packages Size 675 (40 Batteries) / 17.24
102-101-8001 / Thirty Packages Size 10 (120 Batteries) / 47.74
102-101-8002 / Thirty Packages Size 13 (120 Batteries) / 47.74
102-101-8003 / Thirty Packages Size 312 (120 Batteries) / 47.74
102-101-8004 / Thirty Packages Size 675 (120 Batteries) / 47.74
SHIPPING & HANDLING US & CANADA / FREE /
FREE
SHIPPING & HANDLING ELSEWHERE / $ 10.00 / 10.00
TOTAL / $27.29

Method of Payment: ($5.00 Minimum Order)

ÿ Check ÿ Money Order X VISA ÿ MasterCard ÿ American Express ÿ Discover

CC# ______Exp. Date ______Signature ______

Please mail all forms and payment to: Buyer’s Haven

Sales Department

1016 McLean Ave

Saint Paul, MN 55106