[TC]2 - Turning Research Into Reality
Education Programs and Products
Order A Product

There are three ways to order the item(s) that you want. 1) Complete the form and submit it. We will contact you to obtain billing information. 2) You may print the form, write your credit card name, number and expiration date on it and fax to 919-380-2181, 3) you may call 1-800-786-9889 toll free to speak with us.


First Name

Last Name

Company

Position

Street Address

City

State

   Postal Code / Zip

Country:

Phone

Fax

Email


Product Information

Product Name

Price

   Quantity

P.O. #



Billing Information (if different from above)

Name

Street Address

City

State

   Postal Code / Zip

Credit card information should be faxed or mailed. We ask that you do not submit this email reply form with credit card information. Your web browser should not allow you to enter information into these fields. Please FAX this form to us after submission. Please print this form page then fill in the credit card fields manually before faxing.

Card number

Name on card

  

 

Expiration date

 

Month: Year:

 

Security Code:

 

Be sure to print this form before pressing "SUBMIT"

Shipping is via UPS ground service unless otherwise requested. A shipping and handling charge will be added to your total order.

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[TC]² - 5651 Dillard Dr. Cary, NC 27518 - © 2011