ENVIRONMENTAL INSIDER SUBSCRIPTION

Print this form and mail it to:

Environmental Insider, P. O. Box 81762, Austin, TX 78708-1762

Or place your order by phone at (512) 380-0621

Ship To
Employer
Address
City St Zip
Telephone FAX
E-Mail
Corporate, state government rate, @ $325 per year (Internet and/or hard copy, same price)
Small business, 501(c)(3) nonprofit rate, @ $275  per year (Internet and/or hard copy, same price)
Regular rate, via the Internet, @ $150  per year
Add $25 per year for selections mailed via hard copy
Corporate, state government rate, @ $425  per year (add $25 if EI NEWS in hard copy)
Small business, 501(c)(3) nonprofit rate, @ $375  per year (add $25 if EI NEWS in hard copy)
I qualify as a non-profit or local governmental entity and and eligible for the $50 discount on EI Compliance Report; my employer sales tax exemption number is:
We will self-pay any sales taxes due; please delete this item from your invoice.
Please bill me at the address below, referencing Purchase Order No. (if needed).

Bill To (if different)

Name PO#
Address
City St Zip
Telephone FAX

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