Health
Administration Press Order Form
(To complete this form, please print it
out and send it to HAP as directed below.)
Journal
Quantity
Total
Subtotal
__________
Sales
Tax IL residents add 9%; MD residents
add 5%
__________
*Shipping Orders are shipped via UPS within the
continental U.S. and Canada
__________
Total
__________
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Method
of Payment
__Bill
Me
__Checks
should be made payable to Health Administration Press
Credit
Card:
__Visa
__MasterCard
__American
Express
__Discover
__________________________________
___________________________________
Cardholder
Name
Account
Number/Expiration Date
___________________________________
Signature/Date
Ordered
by:
Name
Institution/Title
Address
(no P.O. Box please)
City/State/Zip/Country
Daytime
Phone/Fax
Mail,
phone, or fax your order to:
The Foundation of the American College of Healthcare Executives,
Subscription Services
1 N. Franklin St., Suite 1700, Chicago IL 60606-3529
Phone: (312) 424-9456, Fax: (312) 424-0014