2012 Continuing Education Independent Study Program - (Page C51)
51
order form
BILLING INFORMATION
First Name (Please Print)
Street Address
City
(
State
)
Phone Number
Date of Order (mm/dd/yyyy)
ITEM #
E-Mail Address
APA Member # (required to receive member price)
# OF COPIES
TITLE OF EXAM & BOOK (For additional titles please attach a piece of paper to order form.)
PRICE*
(
)
Phone Number
E-Mail Address
Last Name
Apt or Suite
Zip
SHIPPING INFORMATION (ONLY IF DIFFERENT THAN BILLING ADDRESS)
First Name (Please Print)
Last Name
Street Address
City
Apt or Suite
State
Zip
METHOD OF PAYMENT (CHECK ONE)
Visa MasterCard American Express
Check or Money Order Enclosed
Expiration Date
Account Number
Name of Cardholder as it appears on credit card
(Please print.)
Signature
(Required for all charges and Purchase Orders)
Institutional Purchase Order (PO) number
(PO must be attached to this order form.)
SHIPPING & HANDLING
ORDER SUBTOTAL UP TO $14.99
ORDER SUBTOTAL UP TO $59.99
ORDER SUBTOTAL UP TO $60.00 +
U.S. & Puerto Rico ADDRESS
$5.00
$6.00
10% OF SUBTOTAL
CHECK FOR RUSH SHIPMENT (guarantees shipment within 1–2 business days of receipt) ADD $10.00
TOTAL AMOUNT DUE $
All orders must be prepaid unless accompanied by an institutional purchase order. Allow 7-10 buisness days for UPS delivery (UPS cannot deliver to P.O. boxes). Member
discount applies to orders submitted by members only. *Price subject to change without notice. Checks must be made payable to: AMERICAN PSYCHOLOGICAL
ASSOCIATION. Checks must be made payable through a U.S. bank and be made in U.S. currency.
To order by phone, call toll-free 800-374-2721 (in DC, 202-336-5510); TDD/TTY: 202-336-6123; FAX: 202-336-5502
To order online: www.apa.org/education/ce/index.aspx
You may mail your order to: American Psychological Association; Order Department, P.O. Box 92984; Washington, DC 20090-2984
SUBTOTAL PRICE OF ITEMS
FOR DC RESIDENTS, ADD 6.00% SALES TAX
FOR MD RESIDENTS, ADD 6.00% SALES TAX
NON-U.S. ADDRESS
$15.00
$16.00
$20.00
http://www.apa.org/education/ce/index.aspx
Table of Contents for the Digital Edition of 2012 Continuing Education Independent Study Program
2012 Continuing Education Independent Study Program
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