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: 
                    email address: 
Daytime phone including area code: 
 Purchase order number (optional): 




Check method of payment:
 Check payable to Superintendent of Documents (mail orders only)
 GPO Deposit Account:        credit card no:       expires:(mm/yy)
 VISA  MasterCard  Discover/Novus   


___________________________________________________________
Authorizing signature if mailed or faxed.              1/01                               



Fax form to 202-512-2250.
Phone orders to 202-512-1800 (7:30am-4:30pm EST).
Mail form to Superintendent of Documents, PO Box 371954, Pittsburgh, PA 15250-7954.