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   


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Authorizing signature if mailed or faxed.              4/00