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CORD Slide Bank Order Form

Slide Bank:

_______ This CD-ROM contains both first and second installment of the CORD Slide Bank @ $99.00 per copy

Name: __________________________________________________________________

Institution:________________________________________________________________

Address: ________________________________________________________________

_______________________________________________________________________

City, State, Zip: ___________________________________________________________

Phone: ________________________________ Fax: _____________________________

Email: __________________________________________________________________

Make checks payable to: CORD, 901 N. Washington Avenue, Lansing, MI 48906