NLNAC Publications Order Form

NLNAC PUBLICATIONS ORDER FORM

CONTACT INFORMATION * Required Fields
* Name:
Title:
Company:
* Street Address:
* City, State and Zip
* Telephone:
Fax:
Email

SHIPPING INFORMATION Check if same as Contact Information
Name:
Title:
Company:
Street Address:
City, State and Zip

PUBLICATION	QTY.	UNIT PRICE	AMOUNT
2007-2008 Directory of Accredited Nursing Programs		30.00
2008 Accreditation Manual		34.95

Shipping and Handling Fees: (please refer to NLNAC Publications page for S&H rates)

TOTAL:

Please specify preferred method of payment: Check/Money Order Enclosed Purchase Order Enclosed or to be faxed PO No. ** Call me to pay by credit card over the phone Bill me
Currently, NLNAC does accept credit card payments online. If you wish to pay by credit card, please submit completed form online and you will be contacted to process your credit card by phone. You may also email or fax completed form to:** Jocelyn Pineda, Accounting Specialist Tel: (212) 363-5555 ext.319 Fax: (212) 812-0390 Email: jpineda@nlnac.org TO PAY BY CHECK or PURCHASE ORDER (PO): Print completed form and mail along with payment to: NLNAC P.O. Box 995 Bowling Green Station New York, NY 10274-0995

ADDITIONAL COMMENTS: