C.O.D. and School P.O. Ordering Form Order: Billing Address

Organization Name:
First Name:
Last Name:
E-mail Address:
Phone Number:	( i.e. 111-222-3333)
Fax Number:
Address:
City:
State	Please Select Your State Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming
Zip/Postal Code:
Payment Method:	Paying by C.O.D. . . . . ($5 additional charge for C.O.D. orders)
	Paying with School P.O. . . . . School P.O. Number

Shipping Address ( If different from Above ) Organization Name: First Name: Last Name: Phone Number: ( i.e. 111-222-3333) Address: City: State Please Select Your State Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming Zip/Postal Code: Comments and Questions: