Loch Ness Productions: Planetarium Show Order Form

PLANETARIUM SHOW ORDER FORM

Loch Ness Productions
P. O. Box 1159
Groton, Massachusetts 01450 USA
Phone: +1 978 448 3666
Fax: +1 978 448 3799
Orders: 1-888-4-NESSIE
(toll-free within US)

CHECK:	I've read the Requirements. We have what it takes. (If required) I'll print, sign and mail two copies of the Performance License Agreement.
TELL US WHAT YOU WANT: specify catalog number, and any additional production items.

WHO TO: (required)
Your name

Your E-mail address

Phone Work Home

PLANETARIUM SITE: (where licensed show will be presented):

MESSAGE AREA: Special instructions, additional production items, Purchase Order Number, personal greetings, and suggestions:

SHIP TO: (required) Work Home
Planetarium/Institution

Address

City

State/Province

Country (if not U.S.)

Zip/Postal Code

BILL TO: (if different from SHIP TO)
Planetarium/Institution

Address

City

State/Province

Country (if not U.S.)

Zip/Postal Code

DELIVERY: Handling charges popup window
USPS	Priority Mail First-Class Mail International

FedEx	FedEx Bill to your FedEx account:

PAYMENT: We accept cash, checks, money orders, purchase orders, VISA, Mastercard, Discover, and American Express
Card Account Number	Card Expiration Date
Cardholder Name

NOTE: Submitting this form will send the data to us as regular Internet e-mail. Otherwise, select PRINT in your browser, then mail or fax the printout to us.