I wish to subscribe to the Andrews™ Journal of Orthodontics and Orofacial Harmony™

Cost:     $ 100.00 (USD) US Residents; $ 125.00 (USD) after Dec. 31, 1999
             $ 125.00 (USD) International; $ 150.00 (USD) after Dec. 31, 1999
             Payment in U.S. Dollars payable on a U.S. bank only

_____________________
DATE

______________________________________________________________________________
NAME (please print)

______________________________________________________________________________
ADDRESS (please print)                                             CITY                             STATE

______________________________________________________________________________
ZIP (POSTAL) CODE            COUNTRY                     E-MAIL ADDRESS

______________________________________________________________________________
TELEPHONE NUMBER                                             FAX NUMBER

VISA __ MASTERCARD __     ____________________________________________________
                                               ACCOUNT NUMBER                               EXPIRATION DATE

Mail, phone or fax your subscription information to:
Andrews™ Journal (AJ)
2025 Chatsworth Boulevard
San Diego, CA 92107
Phone (619) 224-0866 or (800) 799-8952
Fax (619) 224-6979

Publisher:
L.A. Wells, Inc.

Sponsor:
Lawrence F. Andrews
Foundation for Orthodontic
Education and Research