WISCAT ORDER FORM Please note that required fields appear by principalbelding

VIEWS: 14 PAGES: 2

									2009 WISCAT ORDER FORM                                                         Print Form     Submit by Email


Please note that required fields appear in blue.

Date Submitted:


Please select a WISCAT ordering option from below:
   A single invoice for $200 covering calendar year January through December 2009.

   Two invoices for $100 (January & July) covering calendar year January through December 2009.

   A single invoice for $200 covering fiscal year September 2009 through August 2010.

   Two invoices for $100 (September & March) covering fiscal year September 2009 through August 2010.

    A single invoice for $100 covering a 6 month period chosen from the options below

         Jan-June 2009         or              July-Dec 2009


Order Information:


Library Name:


WISCAT Code (if known):


Street Address:

P.O. Box:


City:


Zip:


Contact Person:


Phone:


Email:

If your billing information is different from your order information please continue onto the
next page, otherwise click the print or submit buttons at the top of this page.
2009 WISCAT ORDER FORM                                                                           Page 2


Billing Information:


Billing Organization:


Billing Contact:


Street Address:


P.O. Box:


City:

Zip:


Phone:


Email:


Purchase Order Number:



Questions about your order or this form can be directed to Shiela Pollock toll-free at (888) 542-5543
or Shiela.Pollock@dpi.state.wi.us
If you printed this form to FAX or mail the contact information is as follows:

                                     WISCAT Orders
                                     Reference & Loan Library
                                     2109 S Stoughton RD
                                     Madison, WI 53716

                                     FAX: (608) 224-6178

								
To top