Order Reports

Order Form

TO PLACE AN ORDER: Print this page (On your browser tool bar hit file .. .. .. print) -Then-
Fax to: (419) 715-8378 or
Mail to: ALVEST: 833 S. 30th Street, Lincoln, NE 68510, U.S.A.
If paying with check or money order, make payable to ALVEST.

(If you cannot print, you can use a blank piece of paper.)

Name: ________________________________________ Telephone: ____________________

Address: ____________________________________________________________________

City ______________________________________________ St________ Zip _____________

I would like to pay with (circle one):

Credit Card # ___________________________________________ Exp. Date _____________

I would like to order the following reports:

(Use another page if you need more room.)______________________________________________________________________ Cost: _______
______________________________________________________________________ Cost: _______
______________________________________________________________________ Cost: _______
______________________________________________________________________ Cost: _______
______________________________________________________________________ Cost: _______
______________________________________________________________________ Cost: _______
______________________________________________________________________ Cost: _______

I am ordering $ ______________ worth of reports.

Please send the reports via: [EMAIL] [FLOPPY DISK] [ON PAPER]

Please note that e-mail shipping is free. Five dollars will be added to total order if ordered on paper or disk.

Signature _________________________________________