US Government Information

Superintendent of Documents Order Form

To order this publication, print, complete, and forward this order form to the:
Superintendent of Documents, PO Box 371954, Pittsburgh, PA 15250-7954
Fax orders to (202) 512-2250 or Phone orders to (202) 512-1800 (8am-4:30pm EST).

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Order Processing Code: *7864

YES, send me_____ copies of Protecting Human Research Subjects: Institutional Review Board Guidebook, S/N 017-040-00525-3 at $47.50 domestic ($66.00 foreign).

The total cost of my order is $__________. Price includes regular shipping and handling and is subject to change.

                    Personal name: __________________________________

                     Company name: __________________________________

                   Street address: __________________________________

          City, State, Zip Code+4: __________________________________

Daytime phone including area code: __________________________________

 Purchase order number (optional): __________________________________

Check method of payment:

___ Check payable to Superintendent of Documents

___ GPO Deposit Account __ __ __ __ __ __ __ - __

___ VISA  ___ MasterCard  ___ Discover

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(expiration date: mm/yy)     Thank you for your order!

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Authorizing signature                               7/2005