Mail Order Form (Please select this form with your mouse before printing- upon request this form can be e-mail to you if preferred)
mail ComNur.com ,  518 Massasoit Rd., Worcester, MA 01604 USA

                                                                                                                             Subtotal                          
            Massachusetts only) 5% Sales Tax  
            Shipping                                          
            Total                                               
   MasterCard Visa Discover  American Express
         Expiration Date             
List  last three #'s from back of card for,Matercard,Visa & Discover___________________
List last 4 #'s above card # for American Express
         Check Enclosed
Please note orders are not placed until checks clear
We add $30.00 handling charge for returned checks
Please keep a copy of this form for your records