Order Form

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Channelab On-line Order Form

Order Item

$250.00 per copy

* Hard Drive Serial #

* indicates required field

How to get hard drive serial #

* Name:

Title:

Principal Investigator:

Department:

Organization

Address:

Phone:

Fax:

* E-mail:

Special   
Instruction or PO #

Order Type

New Order

Transfer of Registration (Free!  Please indicate reason for transfer in special instruction)

Method of Payment

Check

Purchase Order (Please inidicate PO # or fax us the PO).

Visa

MasterCard

American Express

For credit card payment, we now have SECURED transaction page.  Please complete the credit card transaction after pressing Order Submit button.

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To contact us:
Phone: 770-939-4366
Fax: 770-939-9478