Check one only--please submit a separate payment form for each book.
s D e s i g n Annual 2003 s A d v e r t i s i n g Annual 2003 s P romotions 2
s P h o t o A n n u al 2003 s Annual Reports 8
s Under 30 2003 s P roduct Design 3 s Book Design 3 s Poster Annual 2003
Title of Entry
C o d e #/Category
To t a l s
1
2
3
4
5
6
7
8
9
1 0
Subtotal Entry Fees
Book Title
Re gular Pr i c e
Q u a n t i t y
Advertising Annual 2002
$70.00
$56.00 x
=
Design Annual 2002
$70.00
$56.00 x
=
P romotions 2
$70.00
$56.00 x
=
Photo Annual 2003
$70.00
$56.00 x
=
Annual Reports 8
$70.00
$56.00 x
=
Under 30 2003
$70.00
$56.00 x
=
P roduct Design 3
$70.00
$56.00 x
=
Book Design 3
$70.00
$56.00 x
=
Poster Annual 2003
$ 7 0 . 0 0
$56.00 x
=
Shipping and Handling per book
USA or Europe
$ 1 0
International
$ 2 5
=
NY Residents add 8.25% tax to book order
Subtotal books
Total Entry Fees and Books
s Check (US$, Drawn on US Bank Only) s Int'l. Money Order (US$)
Credit Card: s Visa s MC s AMEX (Charged in US$) s BANK TRANSFER
Card #
Exp. Date:
Cardholder's Name:
Cardholder's Signature:
$
$
Sender's Name
Title
Company
Key Code
Address
City
State
Zip/Postal Code
Country
Phone
Fax
E-mail
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Total
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