Subscription Form

ORDER FORM

WEISBURG ASSOCIATES, LLC

95 Photine Drive

Lowell, MA 01854

Phone: 732-939-7576

Fax (call above number in advance) 732-441-7344

__ New Subscriber __ Renewing Subscriber ___ Number of Subscriptions

Name of School District:

Billing Address and phone/fax:

Name(s), e-mail addresses, and phone numbers of Subscribers:

Price $40 per year for subscriptions not going through subscription agencies

Payment Method

__ P.O # ___________

__ Send Invoice

__ Send Paypal invoice (for credit card payments)

__ Check enclosed

All payments should be made to Weisburg Associates, LLC and sent to the address at the top.