APICS CSCP Kit Order Form
APICS MEMBER # (if member):
NAME:
ADDRESS:
CITY:
STATE:
ZIP:
COMPANY NAME:
WORK PHONE:
HOME:
FAX:
EMAIL:
COMMENTS/QUESTIONS:
MAKE CHECKS PAYABLE TO:	Boston APICS
MAIL PAYMENTS TO:	Ms. Audrey Chretien c/o DePuy Spine 325 Paramount Dr. Raynham MA 02767
COST:	APICS Member - $760.75 + $15.00 S&H Non-Member - $1060.75 + $15.00 S&H