LNP: Order Form: Image Library

IMAGE LIBRARY ORDER FORM
P. O. Box 924 Nederland, Colorado 80466-0924 USA Phone: +1 303 642 7250 Fax: +1 303 642 7249 Orders: 1-888-4-NESSIE (toll-free within US)

TELL US WHAT IMAGES YOU WANT: specify product codes and usage categories (describe your project, if appropriate)

WHO TO: required *
Your Name *

Your E-mail address *

Phone

SITE OR PROJECT NAME: Where licensed images will be used

MESSAGE AREA: Special instructions, Purchase Order Number, and feedback: How did you hear about us?

SHIP TO: Planetarium/Institution/Recipient	Send as gift to recipient
Address *	Work Home
City *
State/Province *
Zip/Postal Code *
Country (if not U.S.)

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

Address

City

State/Province

Zip/Postal Code

Country (if not U.S.)

DELIVERY: * Handling charges popup window
	E-mail attachment / FTP
USPS	Priority Mail First-Class Mail International
FedEx	FedEx Bill to your FedEx account:

PAYMENT: We accept VISA, Mastercard, and Discover cards.
Credit Card Account Number	Card Expiration Date
Cardholder Name

Prefer to mail or fax your order? Here's a