Annals of Internal Medicine
Full-Text CD-ROM Order Form
To order, please print this page, fill in the blanks, and fax to (978) 975-3811.
Please identify the
Annals of Internal Medicine
you want...
Check out our Fall $pecial....Order Now! Special pricing ends December 31, 1999!
Personal Use
CD-ROMs at
US$65
(regularly US$95) each
Quantity:
Total Price:
Institutional Use
CD-ROMs at
US$145
(regularly US$195) each
Quantity:
Total Price:
Network Use
CD-ROMs at
US$245
(regularly US$395) each
Quantity:
Total Price:
Shipping/handling charges
- $10 per disc shipped first class within the US, $30 per disc shipped airmail outside the U.S.
Number of discs:
Total Shipping:
Order Total:
About Yourself...
Name:
Department/
Institution:
Address:
City:
State/Province:
ZIP/Postal Code:
Country:
Telephone Number:
Fax Number:
If you want to pay by credit card...
Credit Card Type:
(MasterCard, VISA or American Express only)
Expiration
Month:
Year:
Credit Card Number:
Issuing Bank:
4-Digit Code:
(a printed number that appears on some cards - including American Express - please provide if available)
Your Authorizing Signature:
If you want to pay by purchase order...
1.
Complete the information above.
2.
Fax this order form along with your approved institutional purchase order for the total order amount (payable in U.S. dollars drawn on a U.S. bank) to 978-975-3811.
If you want to pay by wire transfer...
1.
Complete the information above.
2.
Fax this order form along with a request to us for bankwire transfer information to 978-975-3811. We'll send you the wire details, and your order will be shipped upon confirmation of funds receipt from our bank.
