Please mail or fax your order to:
    Mockingbird Hill
    P.O. Box 5455, Midland, Texas,  79704-5455
    Phone: 800-765-8433  Fax:  432-682-6712


    BILL TO: ___________________________   SHIP TO: ___________________________
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    DATE: ______________________________   F.O.B.: _______MIDLAND______________
    DATE TO SHIP: ______________________   TERMS: _____________________________
    SHIP VIA: __________UPS_____________   P.O. #: ____________________________



    QUAN.    ITEM NO.              ITEM DESCRIPTION             PRICE    AMOUNT
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    METHOD OF PAYMENT
    _____ Net 10 days with institutional purchase order
    _____ Check or money order
    _____ Visa
    _____ MasterCard

    __________________  Card Number
    __________________  Name of Bank on Card
             ____/____  Expiration Date


    ________________________________________
    (authorized signature)

    Shipping and handling charge: 4% of total (for mainland U.S.A. destinations)
    Minimum shipping & handling charge is $4.75.

    YOUR SATISFACTION IS GUARANTEED
    MATERIALS MAY BE RETURNED WITHIN 30
    DAYS FOR REFUND OR EXCHANGE.