ORDER FORM


Facility / Office
 
Contact person
 
Address
 
Suite No
 
City
 
State
 
Zip
 
Phone Number
 
Fax Number
 
Email Address
 
Handbook Quantity
  @$20.00 each (up to 24)
    @$18.00 each (25 or more)
Tax Exempt?
 
   


Shipping charge: $2.50 for first book, $0.25 for each additional book.

We do not accept credit cards. You will receive an
invoice with your book(s).

Tax: per your county (include book total and shipping to determine total tax - per state guidelines)