Please print out the following form and mail it to the address at the bottom to receive your materials. You can also view and print the form in PDF format. If you wish, you may also download and fill out a Microsoft Word version of this form. Once completed, save the document to your hard drive and send it to us by email as an attachment.

Date: _____________________________          IFIA Americas Committee Member?:      YES     NO

Shipping Address Billing Address
Name:
Company:
Address:
Phone:
Fax:
E-mail
PUBLICATION QUANTITY PRICE TOTAL
English Spanish Member Non-Member
Training Record Books $2.00 $8.00
Test Question Books $5.00 $20.00
Subtotal
Shipping and Handling Within the US* Up to $50

$15

$50.01 – $150

$25

$150.01 – $300

$35

Over $300

$50

TOTAL FOR THIS ORDER

*For rush orders, you may provide us with your Fed-X, UPS or DHL account number. For international orders, you must provide us with your shipping account number. A $10 handling charge applies to all orders shipped using your account.

Circle One:  Fed-X   UPS    DHL            Account Number:_____________________________________________________

Total Amount Enclosed**: $_______________________________________________

Send to:

IFIA AC Phone: 703-533-9539
3942 N. Upland Street FAX: 703-533-1612
Arlington, VA 22207 E-mail: ifianac@aol.com

**Payment must accompany all non-member orders. Billing is available to member companies if billed to their US affiliate. Please allow 2 weeks for delivery.