ASPT MANUAL & CEU TEST ORDER FORM
| Last Name ________________________________________ |
First Name ________________________ |
MI ______ |
| Address (No POB#'s) ___________________________________________________ |
Apt. ____ |
| City ____________________________________ |
State ________ |
Zip _________ |
| Phone (______) _________ - ________________ |
Membership number ______________________________ |
|
Description
|
Quantity
|
Each |
Total |
| The Art & Science of Phlebotomy Manual |
_______ |
$40.00 |
$ _________ |
| CEU test for the Art & Science of Phlebotomy Manual |
_______ |
$25.00 |
$ _________ |
|
|
|
|
|
| Refresher Manual CEU test #1 |
_______ |
$25.00 |
$ _________ |
| Refresher Manual CEU test #2 |
_______ |
$25.00 |
$ _________ |
|
|
Paramedical Insurance Examiner Manual |
_______ |
$40.00 |
$ _________ |
| Paramedical Manual CEU test #1 |
_______ |
$25.00 |
$ _________ |
| Paramedical Manual CEU test #2 |
_______ |
$25.00 |
$ _________ |
|
|
Point of Care Modules |
_______ |
$20.00 |
$ _________ |
| Includes self-study test |
Enter Module #
|
_________ |
|
|
Drug Collection Manual |
_______ |
$40.00 |
$ _________ |
| CEU test #1 (urine collection only) |
_______ |
$25.00 |
$ _________ |
| CEU test #2 (urine and blood) |
_______ |
$25.00 |
$ _________ |
|
| Electrocardiography Manual |
_______ |
$30.00 |
$ _________ |
| EKG-CEU test #1 |
_______ |
$25.00 |
$ _________ |
|
| Shipping fees for manual alone |
|
$7.00 |
$ _________ |
| Shipping fees for CEU test alone |
|
$5.00 |
$ _________ |
| Shipping fees for manual and test (when ordered together) |
|
$9.00 |
$ _________ |
|
Check or Money Order # _______________________ TOTAL AMOUNT ENCLOSED
|
$ _________ |
NO CREDIT, DEBIT OR PAYMENTS BY PHONE. CHECKS AND/OR MONEY ORDERS BY UR MAIL ONLY
Make check or money order payable to: American Society of Phlebotomy Technicians (ASPT)
Mail payment and completed order form to: ASPT, PO Box 1831, Hickory, NC 28603
NO REFUNDS ON MANUALS OR TESTS
Each test is equal to 6 hours of CEU's. Do not order a particular CEU test if you have ordered it in previous years.
Your order will be rejected if you do so.
