Order Form

Home Page What is TQ Sample Page

Website is under construction; we are working to allow online ordering. Please do not submit online until website construction is complete.

To order or renew your subscription

print out a copy of this form and mail it along with a check or money order to:

Tyler's Quarterly

P.O. Box 250406

Little Rock, AR 72225-0406

Please make check or money order out to Tyler's Quarterly.

You may fax your order to 501-664-4503 with your credit card information. We accept Visa, MasterCard, American Express, and Discover.

All Tyler's Quarterly subscription orders are PREPAID.

For questions or comments please call 1-866-664-3788 or email us at:

tylersq@comcast.net

Personal Information: (Note: Items in RED are required information)

Please select one: OD MD Other

Name

Organization

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Country

Work Phone

E-mail

Subscription Info: (If ordering more than 5 copies to the same address please call our office for volume discount)

SUBSCRIPTION(S) (BOTH the Professional AND Office Editions)

QTY Domestic USA -$75.00 per year plus $54.00 per year for each additional subscription to the same address.

Outside the United States -$120.00 per year plus $90.00 per year for each additional subscription to the same address.

SUBSCRIPTION(S) (ONLY the Professional Edition)

QTY Domestic USA -$55.00 per year plus $44.00 per year for each additional subscription to the same address.

Outside the United States -$90.00 per year plus $77.00 per year for each additional subscription to the same address.

Please select which issue you would like your subscription to begin:

March June September December

If using a credit card, please select from the drop down menu. Please DO NOT include dashes in the card number:

Expiration Date: MonthYear

Comments:

*Name*
*Organization*
*Street Address*
*Address (cont.)*
*City*
*State/Province*
*Zip/Postal Code*
*Country*
*Work Phone*
*E-mail*