Order Form

Use your browser to print this page, then complete the form and send to the location below:

SIGMA Assessment Systems
P.O. Box 610984
Port Huron, Michigan
USA 48061-0984
Phone: 1.800.265.1285
Fax: 1.800.361.9411

Phone #:			Purchase Order #:
Ship To:			Bill To:
Date shipment needed by:			Email Address:
If your qualifications are not on file with us, a completed Test User Qualifications Form is necessary Name of individual qualified to use these materials:
Quantity	Item #	Item Description		Unit Price	Total
Check/money order enclosed Institutional Purchase Order enclosed. (P.O. #) Visa MasterCard American Express   Card #:   Expiry:   Signature:				Order Subtotal:
				Shipping & Handling: (see below for details)
				Subtotal:
				Tax (6% in Michigan):
				Total:

Shipping & Handling

• 10% or $13.00 (whichever is greater) in the continental U.S. only.
• Prepaid international orders are shipped via airmail. Please inquire about rates.