P.O. Box 3000 Nashua, N.H. 03061-3000

Order Form
TOLL-FREE ORDERING
24 hours a day - 7 days a week
Phone: 800-442-5444 Fax: 800-282-9560
     
 Billing Address: (required) Check if home address   Shipping Address: (if different) Check if home address
PO #
  Date:  
Name:
  
Name:
    
Title/Dept.
  
School:
    
School:
  
Address:
   
Address:
  
City:
    
City:
  
State:
   Zipcode:  
State:
   Zipcode:
Phone:
    
Phone:
  
Email Address:
    
Email Address:
 
             
 Discount     Item Name/Description   Item #   Qty. Price Total Price  
       
  Please indicate your preference for any item(s) not currently available:
  Ship when available Please call to discuss substitutions
       
 
Prepaid by:
   Check/Money Order American Express
      Visa Master Card Discover
 
Credit Card #:
  
 
Exp. Date:
  
 
Name:
  
      As it appears on Credit Card.
 
Signature:
  
 
   
       
 
Total$0.00
Shipping Charges*: $5.00
Sales Tax:
Residents of AZ, CA, MA, OH, TX, WA and Canada, please add applicable sales tax. Exempt residents must provide an exemption certificate.

* An additional charge applies to shipments of living materials:
    1–3 items: $12.50
    4–5 items: $22.00
    6 or more items: $30.00
Grand Total: