Undergraduate Programs

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Please check the items that you would like to order from the following:

BIOL 102 Laboratory Kit, $30 (plus $1.50 sales tax for MD residents only)

*BIOL 101 Video Tape Rental, $70 (plus $3.50 sales tax for MD residents only)**
"Cycles of Life: Exploring Biology"

* Refund will be generated upon return of tapes ($40 for BIOL 101 Video Tape) plus $2.00 sales tax for MD residents only. $1 is charged if tapes need rewinding or packaging is missing.

Payment may be made using VISA, MasterCard, money order, bank cashier's check or certified check.

Indicate method of payment:	Please complete the following if using credit card:
Money Order	Account #
Bank Cashier's Check	Name on Card
Certified Check	Expiration Date
VISA	Amount of Charge $
MasterCard	Date

Cardholder's Signature _____________________________