To order CDs, please fill out this form according to the instructions at the bottom of the page.

General Information

First Name Last Name
Title or Company Name Phone Number
Address
City State Zip

Order and Costs

Quantity Number Ordered
0 - 24 copies at $265.00 per CD
25 - 49 at $235.00 per CD
50 - 74 at $200.00 per CD
75 - 99 at $175.00 per CD
≥100 at $150.00 per CD
Quantity Shipping and Handling
0 - 9 copies at $9.95
10 - 19 copies at $14.95
20 - 24 copies at $19.95

Price includes one CME certificate/CD, shipping, handling, and sales tax per CD on orders of > 25 CD's. For orders of < 25 CD's, shipping, handling, and 8.5% CA state sales tax will be added.

Total Cost : $

Credit Card Information

Cardholder First Name Cardholder Last Name
Address
City State Zip
Card type Card Number Exp. (mm yy)
Signature of Cardholder

Total amount to be Charged:
$

 

Instructions

To pay by check or money order, please fill-in the General Information and Order and Costs portion of the form above, print it, and mail the completed form with your check to:

Center for Disability and the Health Professions c/o Western University of Health Sciences
309 E. Second St.
Pomona, CA 91766-1854

To pay by credit card, also fill-in the credit card portion of this form, print it, and fax the completed form to 909.469.5503 ATTN: Gracie Villarreal.

CDIHP's non-profit tax ID number is 95-3127273. Please make checks payable to "CDIHP - Western University of Health Sciences."

For more information contact CDIHP at 909.469.5441 or e-mail to pathways@westernu.edu

About the CD | Course Description | Demo | CEU | Order Form