Logoware Order Form

Fields Logoware Order Form

Logoware
Fields Institute
222 College Street, 2nd Floor
Toronto, Ontario, M5T 3J1 Canada

or fax this form to:

(416) 348 - 9714

Item Name	Spec's		Qty.	Price	Total
EXAMPLE: Fields Mug				$ 8.00	$
New Logo Fields Print T-Shirt	White	Sml		$15.00	$
		Med
		L
		XL
Fields Embroidered Hat	Khaki			$15.00	$
Fields Mug	Green			$8.00	$
Fields Pen	Silver			$3.00	$
Fields Note Pad	White			$4.00	$
Fields Plastic Bag				$1.00	$
Lecture #1: Sir Michael Atiyah				$30.00	$
Lecture #2: Panel Discussion on the future of mathematics.				$30.00	$
Lecture #3: Maxim Kontsevich				$30.00	$
Lecture #4: Alain Connes				$30.00	$
Lecture #5: Richard Borcherds				$30.00	$
Lecture #6: Vaughan Jones				$30.00	$
Lecture #7: Tom Archibald				$30.00	$
Lecture #8: Michael Monastyrsky				$30.00	$
Lecture #9: John Milnor				$30.00	$
Lecture #10: Timothy Gowers				$30.00	$
Lecture #11: Alan Baker				$30.00	$
Lecture #12: Stephen Smale				$30.00	$

Shipping and Handling Fees For Packaging and Delivery (Canada only) $4.50 on orders up to $15.00 $5.50 on orders from $15.01 to $50.00 $8.50 on orders from $50.01 to $75.00 $10.00 on orders from $75.01 to $100.00 $13.50 on orders over $100.00 (**for USA or International orders, please email: logoware@fields.utoronto.ca )				Total Cost of Items	$
				Add Shipping and Handling Fee	$
Grand Total and Amount Paid:					$


Delivery Information: (please print clearly)
Name:
Mailing Address:
City & Province/State:
Country:
Postal/ZIP Code:
Email address:
Daytime Phone number:

Payment Method:
Cheque Money Order (Made payable to The Fields Institute)
Visa Mastercard	Name on Card:
Expiry: month \ year	Credit Card Number:
Signature: _____________________________________

Print WEB PAGE and Mail or Fax to address above.
Confirmation will be sent by email upon receipt of this form

email inquiries to: logoware@fields.utoronto.ca
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