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ASET Order Form
American Society of Electroneurodiagnostic Technologists,Inc.
6501 East Commerce Ave, Ste. 120, Kansas City, MO 64120 USA
Phone: 816-931-1120 Fax: 816-931-1145 email - info@aset.org

Printable Order Form

Title/Item Member
Price		 Nonmember
Price		 QTY Subtotal
Nerve Conduction Studies from
A to Z by Barbara O. Crout and Bill Flicek

$49.95

$54.95

   $
        $
Ordering Options:
  • Fax completed order form with credit card # to (816)-931-1145
  • Mail completed form with payment to:
    ASET, 6501 East Commerce Ave, Ste. 120, Kansas City, MO 64120 USA
  • Phone: 816-931-1120   Fax: 816-931-1145 email - info@aset.org
Order Total $
$
Shipping & Handling 
U.S. orders add $5.00 for the first item and $1.00 for each additional item. 
(not including free items) 
Call for shipping rates on Canadian and International orders.		 $
TOTAL (Prepayment Required) $
Payment Method All orders must be prepaid

[  ] Check or money order enclosed. Make payable to ASET. 
(Must be payable in U.S. dollars) 
[  ] Charge to: [  ] VISA [  ] MasterCard [  ] Discover Account # _____________________________ Expiration date _________________________
Signature ______________________________
Price category used: [  ]
ASET ID No. _______________

This form may be photocopied for multiple orders

 Please deliver to: 
Name ________________________________ 

Title _________________________________ 

Company _____________________________ 

Address ______________________________ 

_____________________________________ 

City ______________ State ___ Zip _______ 

Daytime Phone ________________________ 

Fax _________________________________ 
DELIVERY:  Most orders are shipped standard UPS. For faster shipping, call (816)-931-1120 for rates.