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SUPPORT SERVICES ABOUT HOW TO HELP ABOUT ThyCa To view |
BOOK
ORDER FORM
Thyroid Cancer: A Guide for Patients Please send me ___ copies of this book at $ 35.00 (US dollars) per book. Books Total $_______ MAILING: No charge
for mailing by Priority Mail to any USA address. Mailing Total
$_______ TOTAL AMOUNT (US
dollars) $_______ PAYMENT METHOD ___My check payable
to ThyCa is enclosed (US dollars) Please charge my ____ Visa _____ Mastercard _____ Discover Card # __________________________________________________ Exp. ____________ Print your name as it appears on card ________________________________________________________________________ Signature ________________________________________________________________________ Provide your address
so we can mail the book to you. Mailing address____________________________________________________________ City ________________________________ State/Province______________ Country___________________ Zip/Postal code ____________
E-mail_____________________________________ Please mail your order to: ThyCa, Inc. Volunteers process
orders and mail the book to you. We do our best to fill orders quickly. |
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