NAME:
SHIPPING ADDRESS:
TELEPHONE:
FAX:
EMAIL:
COPIES AT $60.00 EACH
$
SHIPPING (NORTH AMERICA EACH COPY: $5.00 OTHER LOCATIONS EACH COPY: $10.00)
TOTAL COST
To pay by check, make check payable in US funds, preferably drafted on a US bank, to "MGLS Symposium"
Mail check and order form to:
Fred Paillet MGLS Secretary/Treasurer U.S. Geological Survey, MS 403 PO Box 25046, Denver Federal Center Denver, CO 80225 USA
To pay by credit card, complete the following:
Please indicate type of credit card:
Visa MasterCard
Name as it appears on credit card:
Credit card number:
Expiration date:
month year
Signature:
Fax order form and credit card information to
Fred Paillet MGLS Secretary/Treasurer FAX: (303)236-5968