ScienceProject.com
 A Service of Science Project Corp.
1059 Main Avenue, Clifton, NJ 07011
MAIL/ FAX APPLICATION FORM
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Mail or Fax Orders: (973) 272-1073,
24 hours a day, 7 days a week.
PLEASE PRINT THIS FORM IN ORDER TO MAIL OR FAX YOUR ORDER.

This membership application is only for applicants that for some reason are not able to use the online application.

Student/ Member Information:
Name: ............................................................
Address: .........................................................
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Phone: ...........................................................
Age: ...............................................................
School Name:

 CREDIT CARD HOLDER'S INFORMATION
(if different from left):
Name: ............................................................
Address: ........................................................
City: ................................................................
State: ................................ Zip .......................
E-MAIL (Required):
 

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 MEMBERSHIP DESCRIPTION

FEE

  TERM
   Trial membership with option to view one project guide  $15.00  90 days
   Basic membership with option to view 3 project guides  $30.00  One year
       
   The above fees include $5 manual processing fee.    

 METHOD OF PAYMENT: (Please type)
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(We do not accept checks. Add $2 processing fee if you pay by Money Order)
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ACCOUNT NUMBER:
                                 
EXPIRATION DATE:
           

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I Authorize the total membership fees/ contributions for this application be charged to my account. I also understand that my contributions are not refundable.

SIGNATURE...................................................................

PRINT NAME .................................................................

 
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We do not process orders that are not readable. Email address is required so we can send you a confirmation via email.

Please use the online application if you can. If for some reason you are not able to use the online application, please attach a letter and let us know why.

Mail orders will be reviewed for consideration in the order they are received.