Date_____________ Customer number__________________
Method of payment
(check one):
[ ] Purchase order [ ] Credit card [ ] Check
(payable to CIMC)
Purchase order
number: ___________________ OR
Credit card number: _______________________ Expiration date:__________
[ ] Mastercard [ ] Visa [ ] Discover
(check one)
Bill to:
Attn _________________________________________________
School _______________________________________________
Street address ________________________________________
City_______________________ State_______ ZIP __________
Phone_________________ E-mail _________________________
Ship to:
Attn _________________________________________________
School _______________________________________________
Street address ________________________________________ (no
PO boxes)
City_______________________ State_______ ZIP __________
Phone_________________ E-mail _________________________
__ Check here if this confirms a telephone order
| Material ID# | Quantity | Title | Price | Total |
| Sales tax: For a personal order with an Oklahoma billing address, add Oklahoma sales tax applicable to your shipping address (see sales tax tables). | ||||
| Shipping
within the continental United States (outside the continental U.S., call or fax for shipping rates) - Order total $80 or less, add $8 - Order total $80.01 to $200, add 10% - Order total $200.01 or higher, add 6% |
||||
| Total | ||||
Remittance must be in U.S. dollars drawn on a U.S. bank or world money order. Returns on printed materials must be preauthorized by calling 800.654.4502. Restocking fees and quantity discount adjustments may apply. Multimedia products (videos, DVDs, software) cannot be returned.
Updated 7.30.06
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