Purchase Quotation/Invoice Order Form

Although we prefer payment be made online by credit card, we recognize that sometimes that's not possible. Therefore, we do our best to accommodate invoice-based payments for larger orders/organizations.

If you would like to purchase any of our products and pay by check, please contact us using the form below. Following receipt of your order form, a Purchase Quotation (referencing the provided RFQ/Reference Number) and Invoice (following receipt of a Purchase Order Number) will be sent to the emails listed in the form. See important payment/delivery terms below. For immediate download of program materials, use our credit card-based ordering forms.

Important Payment/Delivery Terms:

  • Payment terms are net 30 days from receipt of Invoice.
  • Program materials are not sent until payment has been received and processed.

Name *
Name
Address *
Address
Phone *
Phone
Accounts Payable Contact Name *
Accounts Payable Contact Name
Accounts Payable Contact Phone Number *
Accounts Payable Contact Phone Number
Are you a tax-exempt provider, organization or facility? *
Please send proof of tax exemption status to cope.dyork@gmail.com and reference this order.
Ship to Name *
Ship to Name
Ship to Address *
Ship to Address
Ship to Phone *
Ship to Phone
Stand-Alone Products
Please indicate the quantity of each product in the box below.
Each stand-alone program purchase includes five student manual/workbooks. Please indicate below which manuals you would like to have included with your order.
Schools - Transitional Event Program Packages
Please indicate the quantity of each product in the box below.
Medical Professionals - Introductory Discounted Program Packages
Please indicate the quantity of each program in the box below.