Please print out and complete
this order form.
Fax with credit card info to: 301-459-5651
Or mail with payment to Society for Vascular Ultrasound
P.O. Box 75491, Baltimore MD 21275-5491
Quantity
Item
Price
Total
Subtotal
Maryland residents please add 6% sales
tax
Shipping*
TOTAL
* Shipping:
US
& Canada:
1-3 items/$8; 4-8 items/$15; More than 8 items/$20.
Outside
US & Canada: Allow 6 weeks for surface mail delivery outside
North America. Add $15 to fees US & Canada fees.
Airmail:
Add $30 per order to fees above.
Name:
SVU member
Address:
City/State/ZIP:
Country:
Daytime Phone No: (required for charges)
Fax No.:
Check: No:
Amt Paid:
MasterCard VISA American Express
Card No.:
Exp. Date:
Billing Address (no P.O. boxes): same as shipping address above
SVU member