Purchase Form

 

 

Name (please print):

 

Address Line 1:

Address Line 2:

Address Line 3:

 

Cost per CD-Rom (including postage and handling):        RM 15.00 (USD 5)

 

Method of payment (please circle the number):

        

1.                  PERSONAL CHEQUES (within Malaysia only)

2.                  money order

3.                  BANKER’S DRAFT

 

Payable to BENDAHARI USM and mail it together with the Purchase Form to the following address:

 

DEKAN

Pusat Pengajian Ilmu Pendidikan

Universiti Sains Malaysia

11800 PENANG, MALAYSIA

Fax No.: 604-6572907

 

 

(PLEASE PRINT THIS PURCHASE FORM)