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Fax to: The Marketing Research Bureau Inc.
Fax: +1 203 891-8855
ORDER FORM BLOOD COLLECTION AND TRANSFUSION
PRICE & DELIVERY The price is $5,750 (five thousand seven hundred and fifty dollars) before December 15, 2006, and $6,250 afterwards. Two hard copies of the report will be delivered in December 2006, and a pdf file will be sent electronically as no extra charge. |
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PAYMENT : |
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BY ENCLOSED CHECK in US dollars, issued on a U.S. Bank or U.S. correspondent bank |
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SUBMISSION OF AN INVOICE Purchase Order # _____________________ (optional) |
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WIRE TRANSFER to Bank of America, Orange, Connecticut 06477,
acct # 00003850938248, routing number and swift code available upon request |
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PAYMENT FOLLOWS |
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SHIPPING ADDRESS: Name ____________________________________________ Title _____________________________________________ Company _________________________________________ Address __________________________________________ City/Postal Code___________________________________ Country ___________________________________________ Telephone _______________ Fax: ____________________ Date _____________________ Email: __________________
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