Three Phase CEUs: ORDER FORM
Name:________________________________________________
Address:______________________________________________
City:____________________________State______Zip ___________County___________
State License Number:______________________________________________________
E-mail:___________________________
Phone:__________________________
Phone
(for future courses and online updates only;will not be shared)
- Print out this form by clicking "File" in the top left corner and select "Print"
- Fill out the required information
- Select the course(s) you would like to receive
- Send this form along with a check or money order (see information below)
To place an order, please follow the steps below:
Ordering instructions:
_____Item 1: Essentials of Radiographic Anatomy
12 Category A CE hours for Florida
Price: $30.00 + tax (Florida only); s/h
_____Item 2: Topics in Radiography Volume I
12 Category A CE hours for Florida
Price: $30.00 + tax (Florida only); s/h
_____Item 3: Fundamentals of Radiographic Pathology
12 Category A CE hours for Florida
Price: $30.00 + tax (Florida only); s/h
_____Item 4: Topics in Radiography Volume II
12 Category A CE hours for Florida
Price: $30.00 + tax (Florida only); s/h
THANK YOU for choosing Three Phase CEUs!
Please make checks payable to:
Three Phase CEUs
Please mail orders to:
Three Phase CEUs
c/o John Fleming
80 Bay Woods Drive
Safety Harbor, FL 34695
Price information:
shipping/handling:
subtotal:
+ sales tax (Florida only)
$2.50
$30.00 single
$32.50
6 %
6.25 %
6.5 %
7 %
7.5 %
$1.95
$2.03
$2.12
$2.28
$2.44
Total:______ Total:______
$60.00 two
$2.50
$62.50
$3.75
$3.91
$4.06
$4.38
$4.69
Phone or fax: (727) 796-0397
You will receive the program packet(s) in a few days. Follow the instructions included in the packet, complete the course and send the required forms back in the envelope provided. You will receive a certificate upon successful completion of the course. It's that easy. Your satisfaction is guaranteed or the total purchase price will be refunded. Have questions? E-mail Three Phase CEUs, attention John Fleming, at: threephaseceus@tampabay.rr.com.