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Supplement Order Form

To purchase a printed copy of an AJCN supplement, print this form, provide price and citation from the list of AJCN supplements, and send to the address listed below.

Reference

Title:________________________________________________________________

Month/Year/Volume:_____________________________________________________

Payment and shipping

For supplement prices see supplement list. Add $5.00 shipping to domestic orders, $10.00 Canada/Mexico, $20.00 to international orders of up to 3 copies. Contact AJCN for international shipping rates of more than 3 copies.

Enclose Visa, MasterCard, or American Express information or check.

Card Number:__________________________________________

Expiration date:________

Name, shipping address (street address required), telephone and fax numbers:

_______________________________________________________________

_______________________________________________________________

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