FINRA Printed Publication Order Form

FINRA Printed Publication Order Form
Please print out this form, neatly write in your order, and mail or fax the completed form to:
FINRA MediaSource
P.O. Box 9403
Gaithersburg, MD 20898-9403
Phone: (240) 386-4200
Fax: (240) 386-4838
Title Price * Quantity Total
Subtotal
PROCESSING FEE ** (The processing fee does not include overnight delivery or international delivery fees.)
Subtotal
Processing Fee
Under $5.00 $0.00
$5.01 to $20.00 $4.95
$20.01 to $40.00 $8.50
$40.01 to $100.00 $10.50
$100.01 to $400.00 $17.00
$400.01 and up Please call for price:
(240) 386-4200
Processing Fee
OVERNIGHT DELIVERY FEE
FINRA provides overnight delivery; please call MediaSource at (240) 386-4200 to determine the charges. If
you prefer to use your own Federal Express or UPS account, please provide your account number:
___________________________
Overnight Delivery Fee
INTERNATIONAL DELIVERY FEE
FINRA provides international delivery; please call MediaSource at (240) 386-4200 to determine the charges .
Payment/ Shipping information on next page
International Delivery Fee
TOTAL

Payment Information
Orders must be prepaid by check, money order or credit card. (Please make checks payable to FINRA.)
PLEASE BE AWARE - THERE ARE NO REFUNDS
r My check/money order is enclosed.
r Please charge my credit card:
r American Express
r Visa
r MasterCard
Account #: Exp. Date: Security Code:
Cardholder’s Name:
Cardholder’s Billing Address:
City: State: Zip:
Cardholder’s Signature (required):
Cardholder’s Phone:
To expedite your credit card order, call FINRA MediaSource at (240) 386-4200.
Shipping Information
r Check here if the shipping address is the same as the credit card holder's billing address. If so, there is no
need to fill out this section.
Name:
Title:
Firm:
Address:
City: State: Zip:
Phone:
* Please note that prices are subject to change without notice.
** Processing fees include tax. Orders are shipped UPS or book rate; please allow three to four weeks for
books/brochures/product orders and six to eight weeks for subscription orders.
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