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JOURNAL OF SUGAR BEET RESEARCH REPRINT ORDER FORM


Please return to: Journal of Sugar Beet Research, c/o ASSBT, 800 Grant Street, # 300, Denver CO 80203

Instructions:
Reprints may be purchased in lots of 100. Complete and return this form to the above-referenced address, with a check, Purchase Order number (when Purchase Order is to follow), or credit card information. Reprints are available at the prices quoted only when ordered prior to publication of the article in the Journal.

Please include the appropriate sum to cover the page charge for your article ($20 per page, full or partial).

Author(s):  _____________________________________________________________________________

Ms. title:   ______________________________________________________________________________


Page Charge:                _________   pages @ $20.00 per page =   $_________________

Number of reprints desired:        _________   Ms. Pages     $_________________

TOTAL:                  $_________________

[ ] Check enclosed

[ ] Purchase Order No. ______________________________________________ will follow     

     Univ/Institute/Agency issuing P.O.: ________________________________________________________

     Send to:    ________________________            Bill to:        ____________________________

                    ________________________                              ____________________________

                    ________________________                              ____________________________    

 
[ ] Credit Card:        [ ] Visa       [ ] Master Card

    Full name and billing address of cardholder, including postal code (Please Print)
    ______________________________________________________________________________________

    ______________________________________________________________________________________

    ______________________________________________________________________________________

    Card Number:  _______________________________    Expiration Date:              

    Card Code (3-digit number following the credit card number on back of card) ___________________


Signature: __________________________________________________



Thank you.