XERCES SOCIETY ORDER FORM
Please print this form, fill it out and send with a check or money order to the address below.

Item/Description Quantity
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Total Amount Enclosed $__________

Prices include shipping and handling within the United States. Most items shipped via US Postal Service Media Mail. If you require a faster or alternative shipping method, please contact us first.

Orders outside the US will be shipped via US Postal Service Surface Mail. If you require a faster method of shipment, please first contact Xerces for an airmail postage quote (fax: 503-233-6794 or e-mail: info@xerces.org).

Make checks in US funds, foreign drafts or international money orders payable to: The Xerces Society. We regret we cannot accept credit cards. Please allow 2 to 3 weeks for delivery.


SHIP TO:

Name_______________________________________________

Address_____________________________________________

____________________________________________________

City_____________________State/Prov________ZIP/Postal Code_____________

Country ____________________


Mail this form along with your check or money order payable to:

The Xerces Society
4828 SE Hawthorne Blvd.
Portland, OR 97215-3252 USA

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