CRN Publications ORDER FORM

Please send me:

Quantity: Total Cost:

_____ copies Before & After DSHEA $ ____________

_____ copies Reference on Evaluating Botanicals $ ____________

Shipping and Handling Charges:

• Domestic S&H - $ 3.00
• International S&H - $ 4.00
  -(+$ 2.00/each book added)
• Federal Express (or equivalent)
  -(Recipient assumes ENTIRE cost)

S&H $ ____________

Order Total $ ____________

Payment:

_____ Check (payable to CRN) enclosed

_____ Credit card: _____ Visa _____ MasterCard_____ American Express

Cardholder Name: _________________________________________________

Card #: ________________________________ Exp. Date: ____________

If using a purchase card credit card, please write the purchase order #: _____________

Name: __________________________________________________________

Company: _______________________________________________________

Address: ________________________________________________________

________________________________________________________

Phone: _________________________ Fax: ______________________

Postage will be charged for bulk orders, call to discuss FedEx/UPS deliveries: (202) 204-7682

Fax order form to CRN at (202) 204-7701

Or e-mail attachment or required info to kstevenson@crnusa.org

For Office Use Only:

Date Received __________ Payment Date __________ Receipt Date ____________