For Office Use
Date: m / d / yr
Payment received:

Package mailed:

Package picked up:

ORDER FORM -- To print out and mail.

Benefiting Explorit's science programs throughout the region.
Your Name: First: ___________________________ Last:______________________________________

Title:______________________________________ Phone:_____________________________________

Business Name:_____________________________ Email ______________________________________

Billing Address for this order: __________________________________________________________________

Address for postal delivery of this order:__________________________________________________________

Cost per book: $19.95; [Members: $17.96]
Number of copies_____ Total price $__________

California Residents, 7.25% Sales Tax $__________

P&H (1-2 bks @ $5.00, Additional books @ $1.00 each) $__________

And, for overseas airmail, an additional $10 per book: $__________
Or, for overseas surface mail, an additional $5 per book: $__________

I will pick up my order from Explorit (P&H will be $0.00)

Total cost of this order $___________________

Method of payment: (Make payment to Explorit Science Center)

Check enclosed

Charge card ____Visa ____Master Card (No other charge cards accepted)

Card Number |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__| Exp Date _____/_____


Name exactly as on card:_____________________________________________

Authorized Signature:_____________________________________________

• Explorit Science Center •
• P.O. Box 1288 • Davis, CA 95617-1288 • 530 756-0191 •