NHF BOOK ORDER FORM

NHF BOOK ORDER FORM

Books Ordered (by title) Price Quantity Total

_________________________________ $ _____ _______ _____

_________________________________ _____ _______ _____

Credit Card Information Visa Mastercard

Credit Card # ____________________________ Calif. Residents 8.25 %

Expiration Date___________________________ sales tax _____

Print name as it appears on card and sign

_________________________________ Subtotal _____

Shipping & Handling

All books are sent UPS

1^st Class. Please include

$ 5.00 for the 1^st book &

$ 1.00 for ea.thereafter

Total Enclosed $ _____

PLEASE PRINT CLEARLY AND

COMPLETE ENTIRE FORM

Name___________________________

Address_________________________

City_____________________________

State______________Zip___________

Please send completed form along with check or

credit card information to:

National Health Federation Phone (___)________

P.O. Box 688, Monrovia, CA. 91017

1-626-357-2181 Fax 1-626-303-0642 Enclosed check amount $ _____