THE RESOURCE CENTER OF EOHSI
Order Form
Name & Title ___________________________________________________________________
Company/School Name ___________________________________________________________
Shipping Address ________________________________________________________________
City ____________________________________________ State ________ Zip ______________
Telephone Number (_________)___________-_________________ Ext. ____________________
E-mail Address __________________________________________________________________
Fax (_______)___________-________________________
Check# ________________________________ Purchase Order# __________________________
PAYMENT:
All orders must be prepaid by check or purchase order payable
to the Resource Center of EOHSI. Prices include shipping and handling.
Canada, add 10%--other countries will be determined case by case. If your
organization is tax exempt, please be sure to include your tax exempt number
below.
ORDER INFORMATION: Please use separate lines for each order. This
form may be reproduced, if necessary.
| CODE |
TITLE |
QUANTITY |
COST |
TOTAL (quantity x cost) |
MEM-C
|
My Environment and Me (SAMPLE) |
2 |
$40 |
$80 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| +6% NJ State Sales Tax or Tax Exempt#___________________________________________________ |
= |
Handling: Canada 10% |
= |
TOTAL CHECK OR PURCHASE ORDER AMOUNT ENCLOSED |
= |
ASK ABOUT QUANTITY DISCOUNTS
Submit completed form to:
RESOURCE CENTER OF EOHSI
Liberty Plaza
335 George Street, Suite 2200, New Brunswick, NJ 08901
(732)235-4988 FAX: (732)235-4960
