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AGT Journal Club

Question Order Form

To order the AGT Journal Club Questions, please fill in the requested information below.
Make check or money order payable to the Association of Genetic Technologists, Inc.

See Journal Club List
Discussion and Question Set for Reading List No. ____________

AGT Members: Non-Members:

$10 for first person
$5 for each additional person
___________
___________
$20 for first person
$10 for each additional person
__________
__________

Total Included _______________

Name of Institution _____________________________________________________

Person or Department___________________________________________________

Address______________________________________________________________

City_______________________ State_____________________Zip Code__________

Phone No.__________________ _____ FAX_________________________________

Method of Payment: Check_______________Visa/Mastercard____________________

Account #:____________________________________ Exp. Date:________________

Signature on Account:___________________________________________________

Mail or fax order form and payment to:

Please make check payable to the
Association of Genetic Technologists, Inc.

  AGT Executive Office
P.O. Box 15945-288
Lenexa, KS 66285

Phone: 913-541-0497
FAX: 913-599-5340

 

 

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