CIS Online Order Form

Oregon Career Information System
1244 University of Oregon
Eugene, OR 97403-1244

Phone: 541.346.3872 or 800.495.1266 in Oregon
Fax: 541.346.3823

Purchase Order #:

Please read How to Order before completing this form.

Order For: (Organization, school, or agency licensing CIS; where CIS will be used!)

Contact for Registration or Ship To: (Please provide the name, work phone, and e-mail address of the person responsible for CIS!)


	Organization or Site
	Name of Contact (CIS Site Coordinator)
	Address 1
	Address 2
	City
	State
	Zip
	Work Phone
	FAX
	Work E-mail

Bill To:


	Office Paying for CIS
	Attention
	Address 1
	Address 2
	City
	State
	Zip
	Work Phone
	FAX
	Work E-mail

Order Code*	Item Description	Quantity**	Fee	Total Price

NOTES:
You must include your Purchase Order # at the top for us to process this order.

Order Code* - If you do not know the Order Code, leave this blank.
Quantity** - You do not have to complete Quantity for CIS site licenses.

Please DO NOT mail a confirmation copy of this Internet order.

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