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ChemTec Publishing Order Department, 38 Earswick Dr.
Toronto, Ontario, M1E 1C6, Canada
Fax:
(416) 981-7875

Date of order:____________________

P.O. Number:____________________
or
Credit Card #____________________ Expiration date ___________

Name on the Card ________________ Signature____________
Publications ordered:

                         Title                           Price     S&H 

                                                         (US$)     (US$)

1. __________________________________________________   _______    

2. __________________________________________________   _______    

3. __________________________________________________   _______    

4. __________________________________________________   _______    

5. __________________________________________________   _______    

6. __________________________________________________   _______   _______


Ship to:

Name:_______________________________

Company:____________________________

Address:________________________________________________________________

Phone:______________________________

Fax:________________________________

Signature  ____________________________  

Bill to (if different):

Name:_______________________________

Company:____________________________

Address:________________________________________________________________

Phone:______________________________

Fax:________________________________