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Purchasing Form

Name	.
Address	.
Street	.
City	.	State	.	Zip	.
Phone	.	Fax	.
E-mail	.

Pricing

Continuing Dental Education:

Item	Item Number	Price
1 USER PACKAGE (1 CD, 1 authorization)	1UCD	$200
ADDED USER (no CD, 1 authorization)	AUCD	$100
4 USER PACKAGE (1 CD, 4 authorizations)	4UCD	$400

Educational Site:

Item	Item Number	Price
SINGLE CD	ES1CD	$200
3 CD	ES3CD	$500
5 CD or MORE	ES5CD	$125 per CD

Order Information

Quantity	Item	Item Number	Price per Item	Item Total
.	.	.	.	.
.	.	.	.	.
.	.	.	.	.
.	.	.	.	.
Subtotal				.
Add Shipping US/Foreign				$5/$25
Total USD				.

Return to:
Ms Jamie Sharp
College of Dentistry
346 Dental Science N
Iowa City, IA USA 52242-1010
Make Checks Payable to: The University of Iowa

All contents copyright © 1992-1997 the Author(s) and the University of Iowa. All rights reserved.