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| First Copy ____________________ | $________________ |
| Additional Copies _______ x $50 | $________________ |
| Total | $________________ |
| Please print or type:
Company name : _____________________________________________________ Address : __________________________________________________________ City : _________________ State : _______________ Zip Code : ______________ Country : __________________ Phone : ________________ Fax : _____________ email : __________________________________________________________ Attention : __________________________________________________________ Indicate : ____ Gov't Agency ____ Non-profit Organization ____Other Organization |
| Rate Chart :
*Rates include shipping |
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| First Copy | Additional Copies | |
| Government (Federal, State, Local);
Non-Profit Organizations |
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| All Other Organizations |
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| To Order |
| 1. Return this completed form along with a Purchase Order. We will invoice you |
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| 2. Return this completed form along with your Corporate Credit Card information: |
| ____ MC ____ VISA ____ Amex ____ Discover |
| Credit Card # ________________________ Expiration Date __________________ |
| Signature________________________ |
| CONTACT : | Report Order |
| PHONE : | 405-325-2429 |
| FAX : | 405-325-2556 |
| E-MAIL : | emc@ou.edu |
| ADDRESS : | The University of Oklahoma
EMC Center 100 East Boyd - SEC R208 Norman, OK 73019 |
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