Order Blank for GEMS Guides and Handbooks

(Please Print and Mail)

Name _______________________ Title(s) Desired:
Address _____________________
____________________________ (1)_____________________________________
Phone_______________________ (2)_____________________________________
Affiliation ____________________ (3)_____________________________________
Tax Number_______________ (4)_____________________________________
Amount Enclosed $ _________ (5)_____________________________________
Cash___ Check___ PO ____ (6)____________________________________

Mail to:

Headwaters Science Center
413 Beltrami Ave.
Bemidji, MN 56601
(218) 444-4472

Thank You!