SRD E-Commerce System

Step 1 of 2 - Mail / Fax Order Form

Please use this Mail / Fax form to generate a NIST TREC Document Database: Disk 4 database order form for faxing or mailing. When complete select the Check Form button to check the data entered. Items with an * are required. You may need to scroll down for the Check Form button.

You can also print a blank Fax Order Form with this Print Blank Fax Order Form for faxing or mailing an order.

Multiple copy discounts are available for this database and are automatically applied when more than one copy is ordered. For more details on discounts please select this Discount Link, call 301-975-2200 or Contact Us. Please note that not all databases are eligible for discounts. All domestic orders are shipped using UPS Ground. Effective immediately, there will be a $30.00 shipping charge for all international shipments of databases via UPS International. Customers will be responsible for their own duties, tax, and VAT. Please contact us at 301-975-2200 or data@nist.gov if you have questions.

Database Data
Database	NIST TREC Document Database: Disk 4
Database Number	Special Database 22
Type	PC
Format	CD-ROM
Unit Price	$90.00
Copies *	(Please call 301-975-2200 or Contact Us if you need to order more than 100 copies.)

Customer Data
Title
First Name *
Middle Name
Last Name *
Suffix
Job Title
Organization *
Type *
Division
Address *
Address (cont)
Address (cont)
City *
State/Province	(Required if the Country is Canada or the United States)
Postal Code *	(Leave blank if Country does not use Postal Codes)
Country *
Email *
Alternate Email
Phone	Ext Fax

Shipping Data
Check here if your Customer and Shipping Address is the same
(Once checked the data will automatically be captured)

Name *
Organization *
Type *
Address *
Address (cont)
Address (cont)
City *
State/Province	(Required if the Country is Canada or the United States)
Postal Code *	(Leave blank if Country does not use Postal Codes)
Country *
Email
Phone	Ext Fax

Billing Data
Note: For Credit Card Purchases the Billing Data needs to be that of the Credit Card holder if the Card Holder Billing Data is different than the Customer Data.

Check here if your Customer and Billing Address is the same
(Once checked the data will automatically be captured)

Name *
Organization *
Type *
Address *
Address (cont)
Address (cont)
City *
State/Province	(Required if the Country is Canada or the United States)
Postal Code *	(Leave blank if Country does not use Postal Codes)
Country *
Email *
Phone	Ext Fax

Payment Data
Payment Type *	Credit Card
P.O. Number	Number
	Name on Card
	Security Code
	Expiration	Month: Year:

All domestic orders are shipped using UPS Ground. Effective immediately, there will be a $30.00 shipping charge for all international shipments of databases via UPS International. There will be additional international shipping costs for multiple copies of databases. Customers will be responsible for their own duties, tax, and VAT. Please contact us at 301-975-2200 or data@nist.gov for questions.

When complete select the Check Form button to validate the entered data.

Please use this Cancel Link to cancel this order and exit the SRD E-Commerce System - Secure Area.