FAX Form for Ordering GASB Subscription Services

1. Print out this page and complete the information on your hard copy.
2. FAX this page to the attention of GASB Subscriptions (203) 847-6045.
Title of Subscription(s):
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Your Name: ______________________________________________________________________
Firm/Company/Affiliation: ___________________________________________________________
Address: ________________________________________________________________________
City/State/ZIP: ____________________________________________________________________
Telephone: ______________________________________________________________________
FAX: ___________________________________________________________________________
Member Status (check one):
Financial Accounting Foundation
Accounting Research Association of the AICPA
Academic
None (Please authorize a charge to your MasterCard or VISA account)
Payment (MasterCard or VISA only):
MasterCard No. __ __ __ __ / __ __ __ __ / __ __ __ __ / __ __ __ __ Expiration Date: ____________

VISA No. __ __ __ __ / __ __ __ __ / __ __ __ __ / __ __ __ __ Expiration Date: ____________

Authorization (Signature): ____________________________________________________________
Check here if you wish to receive a FAX confirmation with a price quotation before we process your order.