Order Form - On Line Forms & Training Manuals

Order Form
Interactive On Line Forms, On Line Training Manuals and Publications

How to use this Form:

n Use one Form per ORDER.

n Type in the Form, on screen response, (fill out applicable blanks).

n Press "TAB" to move between blank spaces. When finished, please print the Form.

n Orders are paid in advance. Check Only.

Your Order and Fees: (please type x in appropriate boxes)

	.
	Build interactive on line forms: $95/Form Number of Ordered Forms X $95 = $
	Develop on line training manuals, company policy... etc.: Contact DMS for a fee quote

TOTAL (selected boxes above): $
Date. Check Number

ORDER INFORMATION: (Please complete only applicable information)

Name	Title .
Company
Address
City
State	Zip Code.
Area Code	Telephone number . FAX number
E - Mail Address
Web Site Address

Please Print Completed Form And Mail It With Your Payment To:
Doctors' Marketing Service
P.O. Box 748
Lake Forest, California 92609-0748, USA

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n		Use one Form per ORDER.
n		Type in the Form, on screen response, (fill out applicable blanks).
n		Press "TAB" to move between blank spaces. When finished, please print the Form.
n		Orders are paid in advance. Check Only.