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Virtual Seminars Order Form Name: Title: Institution:   Shipping Address: Street: City: State: Zip Code: Phone: (include area code) FAX: (include area code) Email:   Billing Address (If same as above, please write same): Street: City: State: Zip Code: Phone: (include area code) FAX: (include area code) Email: Order Information: Creating Internet2 Quantity x Price $ = Total $ Untangling the Web Quantity x Price $ = Total $ Campus Communication Strategies Quantity x Price $ = Total $ Total for Order $ Billing Information: Purchase Order PO Number: PO Amount: Please send us a copy of the purchase order by Fax - 202-293-2853 or Mail - 1112 16th St NW, Suite 600, Washington, D.C. 20036-4823 Additional Information: Are you the CREN Member Rep? Yes     No If not who is? Are you the CREN Billing Rep? Yes     No If not who is? Does your institution have an IT Trainer? If so please list Approximately when would you like the CDs delivered to your campus? Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec of 1998 1999 How did you first learn about the CREN Virtual Seminars? Thank you for ordering our Virtual Seminars! If you have any questions, please contact us. CREN 1112 16th Street NW, Suite 600 Washington, DC 20036 202-331-5366 / 202-293-2853 FAX E-mail: cren@cren.net