Price per booklet
(based on total booklets ordered)
Total
Finding Your Way booklet
# English:
# Spanish:
Total # FYW Booklets:
25-100 booklets: 45¢ each
125-1000 booklets: 40¢ each
1025-2500 booklets: 30¢ each
2525 or more: 25¢ each
$
Mrs. Lee's Story booklet
# Chinese/English:
25-100 booklets: $1.00 each
125 or more: 80¢ each
$
Booklets Total $
Shipping Charges
Booklets Total
Shipping cost
up to $50.00
$6.00
Calif. residents add 8.75% sales tax
$
$51 to $100
$10.00
Shipping (see chart)
$
$101 to $200
$15.00
For out-of-state orders, add $2.00
$
$201 to $300
$20.00
More than $300
Contact CHCD
Total Amount Due
$
Shipping Information
Organization:
Contact person:
Dept.:
Phone:
Email:
Shipping Address (no PO box):
City:
State:
Zip:
Billing Information
Same as Above
Contact person:
Dept.:
Billing Address:
City:
State:
Zip:
PO #:
For PO's, fax this form to (916 851-2818.
To order, complete and print this form.
Send with your check (made payable to CHCD) to: Center for Healthcare Decisions 3400 Data Drive Rancho Cordova, CA 95670
Please allow two weeks for delivery.
If a rush order is needed, contact CHCD at (916) 851-2828 to make arrangements.
