| ___ Check Enclosed |
Payment should be in U.S. funds drawn on a U.S. bank, payable to Journal of Chemical Education. There is a $30 charge for returned checks. |
| ___ Purchase Order |
Institutional purchase orders only. Attach hard copy of PO to this form and send by mail or fax. |
| ___ Credit Card |
American Express, Discover, MasterCard, and VISA accepted. |
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Credit Card # __ __ __ __ - __ __ __ __ - __ __ __ __ - __ __ __ __ CVV2 Code _ _ _ |
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Exp. Date: Month __ __ Year __ __ |
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Signature of Cardholder: ____________________________________ |