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Slosson Digital Order Form

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Bill To:

Billing Name:

Billing Institution:

Billing Address:

Billing City:

Billing State:

Billing Zip:

Billing Fax:

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Ship To:

Shipping Name:

Shipping Instituion:

Shipping Address:

Shipping City:

Shipping State:

Shipping Zip:

Shipping Fax:

Email:

Phone:

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User Qualification:

Highest Degree Attained:

Major Field:

Year:

Institution:

Certificate/License Type

Certifying/Licensing Agency:

Certificate/License Number:

Expiration Date:

Training/Coursework Completed in Use of Tests:

Professional Experience Using Test:

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Payment Information:

Payment Method:

MasterCard

Visa

American Express

Purchase Order (Not 30)

Electronic Bank Transfer

Name on Credit Card:

Credit Card Number:

Expiration Date:

Signature:

Date:

CVC:

Purchase Order Number:

Date of Purchase:

Position:

Product Number #1:

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Unit Price:

Total Price:

Product Number #2:

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Unit Price:

Total Price:

Product Number #3:

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Quantity:

Unit Price:

Total Price:

Product Number #4:

Item Description:

Quantity:

Unit Price:

Total Price:

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Subtotal:

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Shipping/Processing:

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Sales Tax:

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Total Due:

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Promo Code:

Shipping And Processing Charges:

U.S - 10% of merchandise total (USPS only: $5.00 minimum)
Priority Mail - 15% of merchandise total ($10.00 minimum)
UPS - 15% of merchandise total ($10.00 minimum)
Orders Over $3,000 - 7% of merchandise total (U.S orders only)
Orders Over $5,000 - 5% of merchandise total (U.S orders only)
International Orders - 25% of merchandise total ($25.00 minimum)

More Information:

IN, NY, NJ Residents must add applicable taxes
Total Due must be in US Funds only

M&T Bank Electronic Transfer:

Slosson Educational Publications Inc, M&T Bank 135 Hamburg Street, East Aurora NY, 14052, USA
Bank Account Number - 15004211117236
Routing Number - 022000046
SWIFT Code: - MANTUS33
VAT/EIN: - 161001004

Slosson Digital Order Form

Our Location

538 Buffalo Rd

East Aurora

New York, 14052

Get in touch

SLOSSON@SLOSSON.COM

888-756-7766