| Fax | 800-733-2098 |
| Phone | 800-733-2828 |
| Mail: | Houghton Miffliin Company Customer Service 1900 South Batavia Avenue Geneva, IL 60134-3399 |
Your Order No.______________________ Date__________________
Method of Payment:
Check or Money Order: Amount Enclosed $____________________
Bill Our Account No.______________________________________
Mastercard Visa __________|__________|__________|__________
American Express Credit Card Account Number
____________ __________________ ______________________________
Expiration Date Cardholder's Zip Code Signature
Method of Shipment Preferred: _________________________________
Daytime Phone Number ( ) _____________________________________
Prices effective until October 1, 2001. Prices are subject to change.
PLEASE PRINT OR TYPE
Name______________ Position_________
School_____________________________
School Address______________________
City_____________ State___ Zip_______
County/District (optional)______________
Name______________ Position_________
School_____________________________
School Address______________________
City_____________ State___ Zip_______
County/District (optional)______________
Email electronic titles to:
First Name:_________________ Last Name:______________________
Passkey Recipient Email Address:_______________________________
| Catalog Code Number | Description/Title | Quantity | School Price* | Total |
|---|---|---|---|---|
| *School Price includes the regular educational discount (transportation and handling additional). Shipping and handling charges are prepaid and added to the invoice as a separate item. If payment for educational material is enclosed with your order, please add 9% or $4.00, whichever is greater, to cover transportation and handling costs. State and local taxes should be added where they apply. PRICES ARE SUBJECT TO CHANGE WITHOUT NOTICE. | Subtotal | |||
|
9% to cover transportation and handing costs |
||||
| state and local taxes | ||||
| TOTAL | ||||