Print this order form and
mail or FAX it to the address at the bottom of the form. For fastest
service on credit card orders, call 1-800-999-6779.
Outside North America, call 1-703-605-6220. All sales final; prices
subject to change without notice.
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1. Please send me the following reports
and electronic products:
Stock # Title Quantity $/Each Total
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
NOTE: No refunds on electronic products.
____________ Handling charges: $5.00 per order; $12.50
outside North America
____________SUBTOTAL: Reports and electronic products (also
enter below)
2. Please send me a subscription
for the following periodicals:
Stock # Title Subscription Price Total
__________________________________________________________________________________
__________________________________________________________________________________
____________ SUBTOTAL: Periodical subscriptions
____________ SUBTOTAL: Reports and electronic products
(from above)
____________ Add 100% for shipping to addresses outside
North America
____________ TOTAL: Merchandise and shipping charges
3. Ordered by:
Name __________________________________Organization________________________________
Address (Street, City, State, Zip)
__________________________________________________________________________________
Daytime Phone ______________________________
Customer ID #_______________________________
4. Payment Options: Payment or credit
card information MUST accompany all orders. All sales are final.
[ ] Enclosed is my check for $_____________ made payable to ERS-NASS.
Use checks drawn on U.S. banks, cashiers checks, or international
money orders.
Charge my: [ ] VISA [ ] MasterCard [ ] Discover [ ] American Express
Account number _______________________ Expiration Date ________
Mail to: ERS-NASS, 5285 Port Royal Road, Springfield,
VA 22161
FAX to: (703) 605-6900
Order by phone: 1-800-999-6779 (1-703-605-6220
outside the U.S.)
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