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    A Special Offer for visitors to Eisner Safety Consultants' Website:
                     ====================================
                     "International Product Safety News"
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The Newsletter Devoted to Electrical Product Safety Compliance - Est'd 1988
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           INTERNATIONAL PRODUCT SAFETY NEWS - ESC's ORDER FORM
     
     (Using your browser's print function, print this form on your machine 
     or e-mail it to yourself, then complete it and mail or fax to IPSN)

  YES, I need the same high quality information the pros do ............
  Please send my FREE SAMPLE issue and an invoice. If IPSN does not meet
  my needs, I'll return the invoice, marked CANCEL. The FREE SAMPLE issue
  is mine to keep in any case; 

  ( )   One year (6 additional issues)                       US$ 97.00
        Saves $23.00 over the single copy price
        
  ( )   Two years (12 additional issues)                     US$190.00
        Saves $50.00 over the single copy price

  ( ) My check is enclosed.
      (Checks must be in US$ and drawn on a U.S.Bank)

  ( ) Charge to my card; details below

  ( ) Invoice me and add $5.00 for billing & handling             5.00
            
      Purchase Order Number _________________________  
             
  ( ) I'm outside of the US and Canada; Special Handling & 
       AirPost Delivery is $10.00 per year                       ______    

  Signature____________________________________ Total=US$ _____________
                    
  Please Charge my order, in the above amount to:

  ___Visa   ___Master Card   ___Discover Card   ___American Express

  Credit Card Number                            Expiration Date

  ______________________________________        _______________


  Name as it appears on card _________________________________________
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  Name__________________________________________

  Title_________________________________________

  Company_______________________________________

  Address_______________________________________

  Address_______________________________________

  City__________________________State___________

  Post Code______________Country________________

  Phone__________________Fax____________________
 
  e-mail________________________________________
  
  Your company's main line of business:

  _____________________________________________________________

  Your responsibility:

  _____________________________________________________________

  Our 100% NO-RISK GUARANTEE:  You may cancel at anytime for any reason
  and receive a full refund for all unmailed issues.  

  International Product Safety News
  P.O.Box 1561, Dept. ESC
  Middletown, CT 06457-8061 U.S.A.

  Phone:(860) 344.1651     Tollfree Orderline: 1.888.768.2049  
  Fax  :(860) 346.9066     Tollfree Fax Line : 1.888.269.2305
   
Email: escorder@safetylink.com

REF:escorder.txt (11/05/2001)