Publication Request Form

Family Research Laboratory
University of New Hampshire, Durham, NH 03824, USA
Phone: (603) 862-2594 FAX: (603) 862-1122

Only items marked with an * are available.
Please indicate the publication code number and price.
Prepayment is necessary because we do not have the facilities to process purchase orders.

Please indicate the publication code number and price.  Prepayment is necessary because we
 do not have the facilites to process purchase orders.
 
  # and Price          # and Price         # and Price         # and Price
 
 _____$ _____     _____     $ _____   _____     $ _____   _____     $ _____
 
 _____$ _____     _____     $ _____   _____     $ _____   _____     $ _____
 
 _____$ _____     _____     $ _____   _____     $ _____   _____     $ _____
 
 We would appreciate your indicating           Subtotal     $______
 YOUR WORK (Circle one or more):               Postage $ 2.50    
 
 1. College/University teacher
 2. Researcher                                 Total        $______
 3. Human Service provider
 4. Undergraduate student
 5. M.A. student
 6. Ph.D. student
 7. Other     _______________________________              
Send items listed above to:
 

 

 

 YOUR RESEARCH ON CORPORAL PUNISHMENT:    _______________________________
 1. Library study
 2. Empirical study completed           _______________________________
 3. Empirical study in process
 4. Empirical study planned             _______________________________
 
 
   Please make your check payable to the Family Research Laboratory.  If your request is from
 outside the United States please remit by a money order or other instrument in U.S. Dollars.
 
   We do except Visa or Mastercard, Please fill in the following information:
 
 Check one:         Visa:______    Mastercard: _______
 
 Card No: ________________________     Expiration Date:__________ Total $ billed: _________
 
 
 Signature of Card Holder: ___________________________________  Date: _______________