| Ordering by Mail & Fax |
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| By Mail | ||||||||||||
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To order ACCION publications by mail, please print out the form below and send it with your check or money order to: ACCION International Attn: ACCION Publications Department 733 15th St., NW, Suite 700 Washington, DC 20005 USA |
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| By Fax | ||||||||||||
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Fax credit card orders to: ACCION Publications Department (202) 393-5115 |
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Please make checks and money orders payable to ACCION International and in U.S. dollars. If you choose to use your credit card, please fill in the required information at the bottom of the form.
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| Volume Discounts | ||||||||||||
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| Shipping & Handling* | ||||||||||||
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| * Customers are responsible for all customs and brokerage fees. | ||||||||||||
| ORDER FORM |
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Last Name:_____________________________________ First Name:_____________________________________ Middle Initial:___________________________________ Company:______________________________________(if applicable) Title:__________________________________________(if applicable) Address:________________________________________ City:___________________________________________ State/Province:______Zip/Postal Code:___________ Country:________________________________________ Daytime Telephone:_______________________________ Evening Telephone:_______________________________ Fax:____________________________________________ Email Address:___________________________________ Credit Card:(check one) ____VISA ____MASTERCARD ____AMERICAN EXPRESS Credit card number:________________________________ Expiration date:___________________________________ Signature:________________________________________ Qty. Title or Code (e.g. M9) Unit Price Total Amount ________ _______________________ __________ _______ ________ _______________________ __________ _______ ________ _______________________ __________ _______ ________ _______________________ __________ _______ ________ _______________________ __________ _______ ________ _______________________ __________ _______ ________ _______________________ __________ _______ ________ _______________________ __________ _______ ________ _______________________ __________ _______ ________ _______________________ __________ _______ Subtotal of Publications _$_________ _________ Less Volume Discount __$________ __________(if applicable) Shipping and Handling __$________ __________(see above) 5% service charge __$____________ __________(credit card orders) TOTAL $__________ _______ |
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