Human Research Report Internet Discount Form

INTERNET DISCOUNT FORM for "Human Research Report"

Available to NEW subscribers only
("New" subscribers are subscribers whose employing organization has not
subscribed to the Human Research Report for 12 months or more)

YES, I want to keep up-to-date on the risks of research with human subjects. Enter my NEW one-year subscription to the monthly "Human Research Report" at the special Internet Discount price of only $314 ($51 OFF regular price).*

I will enclose a check or money order for $314. Please make payment to the Human Research Report.

- OR -

Bill me for $314.

- AND -
Use our Purchase Order # (optional)

- OR -

Charge my credit card for $314.

Note: Payment must be direct from the subscriber (i.e., payment cannot be accepted from third parties such as subscription services). The Federal Identification Number for The Deem Corporation (publisher of the Human Research Report) is 47-0677198.

- AND -

I want extra copies each month for a year (for committee members, colleagues, etc.) at only $49/yr. for each extra subscriber. Extra copies are sent to the same address as the initial single copy.

International shipping: for Canada/Mexico, add $36 U.S. for the first copy and $24 U.S. for each extra copy annually; for all other countries, add $86 U.S. for the first copy and $36 U.S. for each extra copy annually.

Send My Subscription to:

* = required information

*Name (John Q. Public):	.
Degree (if desired):
Title:
Department/Division:
Room, Mail Code, etc.
*Organization:
*Street or PO Box:
*City/State:
*Zip Code:
*Country:	if other:
*Telephone:	- -
*Fax:	- -
*E-mail:
Please choose from the following list to tell us how you found out about this Web site's Internet Discount Form.
Comment:
WARNING! Please review your information above carefully. Once you click on the "Submit" button, the information cannot be changed.
	For Check/Money Order and Credit Card orders click on the button for a printer-friendly form to fax or mail with your payment. For "Bill me" orders, click the button to submit the information directly to the Human Research Report for automatic processing.

Refund Guarantee: You have up to three months to cancel after you subscribe, and you will still get a 100% refund--and you can keep all the issues you received as well! Cancellations after three months receive a prorated refund for all unmailed copies of the newsletter.