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2003 Research and Beyond Conference VCR Tape Order Form

 

 

 

 

 

 

 

 

 

 

 

 

 

Print and fill out this form (please print), and send with your check or credit card ordering information to:

Spastic Paraplegia Foundation

209 Park Rd.

Chelmsford, MA 01824.

# of VCR tapes ($13 each): _______
 Total price for tapes: $ _______

Handling and Shipping is $5 per item.

Check enclosed: $_________

Or:

Charge $ _______ to my:

  #_______________________________  Exp. Date: ________________

  #_______________________________  Exp. Date: ________________

Name:

Street:

Town:

State and Zip:

Email: 

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