3400 Ave. of the Arts, Suite C-305, Costa Mesa, CA 92626 Phone: (714) 662-1280 / Fax: (714) 662-6966 Email: compliance2000@dhenvironmental.com
Order Form SHIPPING INFORMATION Name: Company: Address 1: Address 2: City: State: State AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA DC WV WI WY Zip: E-Mail: PLACE ORDER ITEM COST QTY TOTAL VIDEO #1: ENVIRONMENTAL RESPONSE, INJURY AND ILLNESS PREVENTION, AND SAFETY Video #1 (English version) $169.50 Video #1 (Spanish version) $169.50 Certificates and Review Questions (English) $10.00 Certificates and Review Questions (Spanish) $10.00 Instructor Manual (English only) $39.00 VIDEO #2: HAZARD COMMUNICATION, RIGHT-TO-KNOW, AND HAZARDOUS MATERIALS MANAGEMENT Video #2 (English version) $169.50 Video #2 (Spanish version) $169.50 Certificates and Review Questions (English) $10.00 Certificates and Review Questions (Spanish) $10.00 Instructor Manual (English only) $39.00 SUBTOTAL SHIPPING AND HANDLING $ 7.95 GRAND TOTAL Check or money order payable to: COMPLIANCE 2000 for GRAND TOTAL amount. Print out form and mail with check to: COMPLIANCE 2000 3400 Ave. of the Arts, Suite C-305 Costa Mesa, CA 92626 Credit Card (Paypal)
SHIPPING INFORMATION Name: Company: Address 1: Address 2: City: State: State AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA DC WV WI WY Zip: E-Mail: PLACE ORDER ITEM COST QTY TOTAL VIDEO #1: ENVIRONMENTAL RESPONSE, INJURY AND ILLNESS PREVENTION, AND SAFETY Video #1 (English version) $169.50 Video #1 (Spanish version) $169.50 Certificates and Review Questions (English) $10.00 Certificates and Review Questions (Spanish) $10.00 Instructor Manual (English only) $39.00 VIDEO #2: HAZARD COMMUNICATION, RIGHT-TO-KNOW, AND HAZARDOUS MATERIALS MANAGEMENT Video #2 (English version) $169.50 Video #2 (Spanish version) $169.50 Certificates and Review Questions (English) $10.00 Certificates and Review Questions (Spanish) $10.00 Instructor Manual (English only) $39.00 SUBTOTAL SHIPPING AND HANDLING $ 7.95 GRAND TOTAL Check or money order payable to: COMPLIANCE 2000 for GRAND TOTAL amount. Print out form and mail with check to: COMPLIANCE 2000 3400 Ave. of the Arts, Suite C-305 Costa Mesa, CA 92626 Credit Card (Paypal)
Name:
Company:
Address 1:
Address 2:
City:
State: State AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA DC WV WI WY
Zip:
E-Mail:
ITEM
COST
QTY
TOTAL
Video #1 (English version)
$169.50
Video #1 (Spanish version)
Certificates and Review Questions (English)
$10.00
Certificates and Review Questions (Spanish)
Instructor Manual (English only)
$39.00
Video #2 (English version)
Video #2 (Spanish version)
SUBTOTAL
SHIPPING AND HANDLING
$ 7.95
GRAND TOTAL
Check or money order payable to: COMPLIANCE 2000 for GRAND TOTAL amount. Print out form and mail with check to:
COMPLIANCE 2000 3400 Ave. of the Arts, Suite C-305 Costa Mesa, CA 92626
Credit Card (Paypal)
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