2009 Monograph Order Form

Qty. Material Unit Price Total Cost
  Culturally Sensitive Design for Long-Term Care Facilities Monograph & Quiz US $115  
  Structures in Interior Design Monograph & Quiz US $115  
  Creating Sustainable Interiors Monograph & Quiz US $115  
  ADA Guidelines Monograph & Quiz US $115  
  Ethical Decision-Making for Designers Monograph & Quiz US $115  
Sub Total All Items  $
Less 10% for active NCIDQ Certificate holders.
Enter your Certificate number (include leading zeros).
___|___|___|___|___|___
Orders shipped to Washington DC, add 5.75% sales tax  $
Plus Postage & Handling (U.S. and Canada only)  $7.25
GRAND TOTAL  $

Shipping and Payment

Name _______________________________________________ Company _________________________________________
Shipping Address________________________________________________________________________________________
City __________________________________________________ State/Prov ______ ZIP/PC _____________________
Phone ___________________________________ Fax ________________________________
E-mail ___________________________________________________________________

Billing Address (if different then shipping)_________________________________________________________________
City ___________________________________________________ State/Prov _________ ZIP/PC _____________________
Total Order Amount in U.S. Dollars:$_______________________ Check Number __________________
Card # (Visa/MC/AmEx/Disc) __________________________ Exp Date ___________ Security Code (3 digit #) ______

Signature (if paying by credit card)_____________________________________________________________________