The Rivers Project Merchandise Order Form
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ITEM |
QTY |
PRICE |
TOTAL |
Shipping Address |
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|
Books |
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| Aquatic Entomology | $ 40.00 |
Name |
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|
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$ 5.00 |
|
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$ 21.00 |
|
School/Company Name |
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$ 12.00 |
|
Street Address |
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$ 20.00 |
City |
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|
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$ 15.00 |
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Curriculum |
State | Zip | |||||
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$ 25.00 |
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$ 25.00 |
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Phone Number(circle: Work or Home) |
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$ 25.00 |
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$ 25.00 |
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Email Address (circle: Work or Home) |
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$ 25.00 |
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|
$ 25.00 |
Shipping Instructions (check one) |
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Early Childhood Books |
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$ 28.00 |
Library Rate: _____ 1st Class: ______ |
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$ 28.00 |
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$ 16.00 |
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Priority Mail: ______ UPS: _____ |
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$ 10.00 |
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$ 15.00 |
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$ 15.00 |
Date picked up:______________ |
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|
Science Adventures |
$ 19.00 |
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| Pre-School Math | $ 19.00 | ||||||
|
Groundwater Materials |
PAYMENT |
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|
|
$ 175.00 |
|
check # |
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|
$ 12.00 |
____________ $____________ |
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Purchase |
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Order#:_________________ |
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Supplies |
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$ 6.00 |
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Charge: Visa MasterCard |
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$ 8.50 |
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$ 9.00 |
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Card # |
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$ 9.00 |
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$ 9.00 |
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Expiration Date |
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|
Tape Measure (50 meters) |
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$ 6.00 |
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Signature |
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|
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$ 5.00 |
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|
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$ 29.00 |
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| D Net / Aquatic Handle | $ 29.00 | Send order with payment to: | |||||
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Box 2222, Alumni Hall |
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|
Edwardsville, IL 62026-2222 |
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FAX: 618-650-3624 |
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Email: rivers@siue.edu |
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Zebra Mussel Materials |
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Website: |
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$ 12.00 |
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$ 18.00 |
|
Dr. Robert Williams |
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FOR OFFICE USE ONLY: |
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Subtotal |
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Professor Emeritus |
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Bill sent: _________________________________ |
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Shipping 10% |
|
Project Director |
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Date shipped: ____ Partial _____ Complete_____ |
TOTAL DUE |
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Revised 12/10/2007