This is NOT an ONLINE FORM, simply a TEXT FILE Just print it out [File -> Print] and Mail it to us. ---------------------------------------------------------------------------- FROM: Roca Redonda Press PO Box 132 Bulverde TX 78163 TO: NAME ___________________________________________________________________ ADDRESS ___________________________________________________________________ CITY ______________________________ STATE ________ ZIP________________ The above is your Mailing Label. Please PRINT clearly. ----------------------------------------------------------------------------- Please SEND ME the following number of cards: TEE - Quick Reference __________ "The TEE Card"™ TEE - Twenty Card __________ Complete TEE Exam, 20 views USG - Regional Block __________ Ultrasound Guided Block Card TEE Cards Pricing (See Special Offer Below): 1 - 3 cards: $18.98 ea per Card 4 - 10 cards: $17.98 ea per Card 11 - 20 cards: $16.98 ea per Card USG Block Card Pricing (Special Introductory Price): 1 - 3 cards: $19.95 ea per Card 4 - 10 cards: $18.95 ea per Card 11 - 20 cards: $17.95 ea per Card Shipping & Handling (per ORDER, All card types): 1 - 3 cards add $2.98 per order (NOT per Card) 4 - 10 cards add $5.98 per order 11 - 20 cards add $9.98 per order TEE-Cards Subtotal ______________ USG-Block Cards Subtotal ______________ Sales Tax 8% ______________ (Texas only) Shipping & Handling ______________ TOTAL ENCLOSED: ______________ INDIVIDUAL PRACTITONIER Special Rebate: Order One "TEE Card" and One "TEE Twenty" Receive $5.00 REBATE Plus FREE SHIPPING SPECIAL PRICING for more than 20 cards! Please email: info@rocaredondapress.com for special quantity pricing. For ORDER CONFIRMATION and shipping date, Please include your email address. email: _____________________________________________________________ Roca Redonda Press thanks you for your order! info@RocaRedondaPress.com www.RocaRedondaPress.com ____________________________________________________________________________ NOTE: This is NOT an ONLINE FORM, simply a TEXT FILE Please print it out [File -> Print] Then mail (with check or money order) to: Roca Redonda Press PO Box 132 Bulverde TX 78163