| "SHIP TO" INFORMATION (please print) |
|---|
| Name/Organization |
| Street |
| City/State/Zip |
| Telephone or Email |
| INSTITUTION $12 per copy | INDIVIDUAL $8 per copy |
| |||
|---|---|---|---|---|---|
| Enter Quantity | U.S. Dollars | Enter Quantity | U.S. Dollars | Total Due | |
| NuMuse Issue 1 |
| $12.00 | $8.00 | ||
| NuMuse Issue 2 | $12.00 | $8.00 | |||
| NuMuse Issue 3 | $12.00 | $8.00 | |||
| NuMuse Issue 4 | $12.00 | $8.00 | |||
| NuMuse Issue 5 | $12.00 | $8.00 | |||
| NuMuse Issue 6 | $12.00 | $8.00 | |||
| NuMuse Issue 7 | $12.00 | $8.00 | |||
| No charge for shipping on mail orders | $ | ||||