PUBLICATION ORDER FORM

To request a copy please fill out the following form as completely as possible.  Then click the "Print Request Form" button at the bottom of this page and mail this form along with full payment to  the address below.

Pub # Publication title Price Quantity Total

Subtotal
Shipping
Sales Tax*
Amount Due

Shipping and Handling Fees (nonrefundable)
$10.00 or less...............$3.00          $80.01 - $100.00..............$8.00
$10.01 - $20.00............$4.00          more than $100.00.....................10% of total order
$20.01 - $40.00............$5.00          Orders from Canada and Mexico, add 15%
$40.01 - $60.00............$6.00          Orders from all other countries, add 30%
$60.01 - $80.00............$7.00                                                             

  *Wyoming residents add 6% sales tax. Tax exempt organizations must send "proof of exemption" with order.


SHIPPING & BILLING INFORMATION


Name   ________________________ Address ________________________
Company    ________________________ City ________________________
Phone   (        )          State ________________________
Fax   (        ) Zip ________________________

Payment Information

Payment can be made by credit card (MasterCard or Visa only), check, money order, or cash. Please complete this form and send it with full payment to:

University of Wyoming
Ag Resource Center
Department 3313
1000 E. University Ave.
Laramie, WY 82072

Credit Card Information

If you wish to pay for your order with a Visa or MasterCard, please complete all of the information below and sign your name. Please print card information clearly.

Name (as shown on card): ______________________________________
Card Number:                            ____-____-____-____ Expires: ___/_____(example 06/11)
Signature:________________________________________