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Please
print this sheet and send by fax or mail. |
Contact Information
| Name: | |
| Agency: | |
| Street Address: | |
| City: | |
| State/Province: | Zip/Postal Code: |
| Country: | E-mail: |
| Phone: | Fax: |
| Certification Type: | Certification Number: |
Book + Test Registration
Book
Titles |
Test |
Regular Cost of Tests | Consumer/
Family Cost of Tests |
Test Total |
Books |
Regular Cost
of Books |
Consumer/
Family Cost of Books |
Total
|
|
| Principled Leadership | _____ | @ $100 | @ $60 | _______ | ______ | @$59.95 | @ $35.97 | _______ | |
| Recovery from Severe Mental Illnesses, Vol 2 | _____ | @ $100 | @ $60 | _______ | ______ | @$49.95 | @ $29.97 | _______ | |
| Recovery from Severe Mental Illnesses, Vol 1 | _____ | @ $100 | @ $60 | _______ | ______ | @$49.95 | @ $29.97 | _______ | |
| Recovery Workbook II: Connectedness | _____ | @ $100 | @ $60 | _______ | ______ | @$31.95 | @ $19.17 | _______ | |
| Comprehensive Guide for Integrated Treatment of People with Co-Occurring Disorders | _____ | @ $100 | @ $60 | _______ | ______ | @$69.95 | @ $41.97 |
_______ | |
| Role of the Family in Psychiatric Rehabilitation |
_____ | @ $100 | @ $60 | _______ | ______ | @$32.95 | @ $19.77 |
_______ | |
| Psychiatric Rehabilitation,
2nd edition |
_____ | @ $100 | @ $60 | _______ | ______ | @$79.95 | @ $47.97 | _______ | |
| Readings in Psychiatric Rehabilitation | _____ | @ $100 | @ $60 | _______ | ____ | @$34.95 | @ $20.97 | _______ | |
| Psychological & Social
Aspects of Psychiatric Disability |
_____ | @ $100 | @ $60 | _______ | _____ | @$44.95 | @ $26.97 | _______ | |
Recovery |
_____ | @ $100 |
@ $60 | _______ | _______ | ||||
| The Recovery Workbook | _____ | @$29.95 | @ $17.97 | _______ | |||||
| The Experience of Recovery | _____ | @$10.00 | @ $10.00 | _______ | |||||
| Subtotal for Books |
+ |
_______ |
|||||||
| Shipping
for books only |
_______ | ||||||||
| TOTAL |
_______ | _______ | =_______ | ||||||
Shipping and Handling for the total cost of books only |
||
| Book subtotal | Cost Continental U.S. |
Cost Alaska, Hawaii, and outside U.S. |
| $0 - $49 | $5 | $10 |
| $50 - $99 | 10% of total | 20% of total |
| $100 - $499 | 5% of total | 20% of total |
| $500+ | 3% of total | 20% of total |
Payment Method
Enclosed
is a check(s) made payable to Boston University.
Payment
must be in U.S. funds by U.S. bank draft or international money order.
| Please charge my credit card | Visa | MasterCard | Discover |
| Card Account Number: | |||
| Expiration Date: | |||
| Signature of Authorized Buyer: | |||
Send Order Form to:
Sue McNamara, MS, CRC, CPRP
Professional Development Program
Boston University Center for Psychiatric Rehabilitation
940 Commonwealth Avenue West
Boston, MA 02215
FAX: 617/353-9209
PHONE: 617/358-2574
e-mail: suemac@bu.edu
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