Credit Card Order Form Handbook for Practicum Students and Interns in Educational Administration with accompanying online serverside software

Credit card orders via the World Wide Web are never completely secure. If you have had problems in the past with your on-line orders to other companies or simply want to feel more secure, you can always phone your order in to (262) 241-8347.

Your First and Last Name

Address (Line 1)

Address (Line 2)

City, State, Zipcode

PHONE: (Don't forget area code)

FAX (area code, number)

Your Complete Email Address

Credit Card Type (Select from pull-down menu) Select one only please. Visa Master Charge American Express

Type your name exactly as it is on the card.

Complete Expiration Date.

Type your credit card number exactly as it is on the card

By clicking below, your credit card will be charged the introductory price of: $39.95 + $8.50 UPS shipping and handling + $2.42 credit card charge = Grand total of $50.87