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: