Official Order Form for "Water, Land, People, &Conflict"

Print the following order form, fill it out, and mail or fax it to us. Your email address is required. (In case there is a question about your order.)

OUR MAILING ADDRESS:

Center for Defense Information, 6th Floor, 1779 Massachusetts Avenue, NW, Washington, DC 20036

OUR FAX NUMBER:

202-462-4559

Please make all checks or money orders payable to: Center for Defense Information

________ No. of VHS copies

$19 (U.S.) Cost per VHS cassette

________ Total

Name: ______________________________________

email address: ________________________________ - required

Phone: ______________________________________ - optional

Street address: ________________________________

City: ________________________________________

State or Province: ____________________ ZIP/Postal Code: __________

Country: ______________________________ (Additional shipping charges for Intl. orders)

PAYMENT METHOD:

VISA __ Mastercard __ Personal check __Money Order

IF PAYING BY CREDIT CARD:

Person's name on card: _____________________________________

Credit Card Number: _____________________________________

Exp. Date: ___________

Cardholder's signature required: ______________________________

PLEASE FILL OUT THIS SECTION IF YOU WOULD

LIKE YOUR ORDER SHIPPED TO ANOTHER ADDRESS

NOTE: If the "ship to" name and address differs from the name and address of the cardholder, the phone number and email address of the person listed above is required for verification of the order. If we can't contact the cardholder for verification, your order will not be filled! (This it to help prevent credit card fraud or abuse.)

Name: ____________________________________

Street address: ______________________________

City: ______________________________

State/Province: ____________________ ZIP/Postal Code: __________

Country: ______________________________