CD-ROM ORDER FORM
Tablet Press Instrumentation
Please print, complete, and mail this form to address
shown below.
Name: |
If you are an AAPS member, please enter member number: |
Organization: |
Address: |
City-State-Zip: |
Daytime phone: |
FAX number: |
E-mail address (print very clearly): |
Purchase Fees:
Product: | Members: | Nonmembers: |
CD-ROM: Tablet Press Instrumentation | $150 | $225 |
4 1/2% Sales Tax for Virginia Residents Only | $6.75 | $10.13 |
Total amount submitted: ________
Payment by check: | [ ] Check (Check Number _____________ Payable to AAPS in U.S. dollars, drawn on a U.S. bank. |
Please charge my: | [ ] Visa | [ ] MasterCard | [ ] American Express | [ ] Discover |
Card Number: | Expiration Date: |
Cardholder Name (Print) | Auth. Signature:
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Please FAX or mail the completed purchase form to: |