Article Information:

Author's Name (lead author if applicable): __________________________________________

Article Title: __________________________________________

Published Year ____ Vol. ____ # ____ Pages ____ to ____

Reprints requested __________

Would you like a journal style cover?  Yes __      No __

Do the reprints need to be shrink wrapped or bundled?   Yes __      No __

If so - quantities per bundle? ______(Multiples of 25 please)

For additional information, please contact Janet Hulbig at 267-566-0270 or email at
jhulbig@aol.com

Bill To:

Name: __________________________________________

Institution or affiliation: __________________________________________

Address __________________________________________

City: _____________ State: _____________ ZIP: _______

Country: __________________________________________

Phone: ______________________ Fax: ____________________

Email: __________________________________________

Ship To:

Name: __________________________________________

Institution or affiliation: __________________________________________

Address __________________________________________

City: _____________ State: _____________ ZIP: _______

Country: __________________________________________