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NAME □ Visa □ American Express □ MasterCard □ Discover Account : LIBRARY/SCHOOL Expiration date: ADDRESS Name on card (please print): Signature: CITY STATE PHONE FAX ZIP CODE B A C K O R D E R I N F O R M AT I O N : EMAIL ADDRESS ACCOUNT AUTHORIZED SIGNATURE TITLE □ NO BACKORDERS □ YES, YOU MAY BACKORDER TITLES Backorder cancellation date: ISBN T H A N K YO U FO R YO U R O R D E R QTY..
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