National Board Reprints Part I & II Bulk Order Form 2015

National Board Reprints Part I & II
Bulk Order Form 2015
Shipping Address:
(Please type or print clearly)
Last Name
First Name
Middle Initial
Title
School
(ASDA cannot ship to P.O. Boxes)
Street Address
City
State
Daytime Phone Number
Email Address
Part I
Quantity/Price per set
(10-24) $243
(25-49) $230
(50-99) $216
(100+) $203
Part II
Quantity/Price per set
(10-24) $170
(25-50) $161
(50-99) $151
(100+) $142
Apartment Number
Zip Code
Savings of
10% Discount
15% Discount
20% Discount
25% Discount
Call for shipping quote
Order Information:
National Board Reprints Part I Set (G-N)
National Board Reprints Part II Set (J-M)
Cost Per
Set
Quantity
Total
Amount
$ ______
______
______
$ ______
______
______
Shipping will be calculated based on the weight of
each order. Please call the central office for a shipping
quote 312-440-7603
______
TOTAL
______
* Full payment must be received before orders are shipped. Shipping may take 5-7 business days. Orders must be shipped to one address and will require a signature.
* Only one method of payment is accepted for each order. Part I & Part II cannot be combined for quantity discount. Bulk orders are not accepted online.
*National Board Reprints are prohibited from copying or reselling.
Payment Method (check one box that applies):
□
Check/Money Order
(Mail checks with this form to:
ASDA, 211 E Chicago Ave, Ste 700, Chicago, IL 60611)
Credit Card Number
Exp. Date (MM/YY)
Signature
K:\Employee Documents\Ellen\NBRs\2015 NBR Bulk Order Form-REVISED.docx
□ VISA/Mastercard
Fax or e-mail order form to Ellen Ryan at 312-440-2820 or Ellen@asdanet.org
K:\Employee Documents\Ellen\NBRs\2015 NBR Bulk Order Form-REVISED.docx