IPR8orderform

Subscription Form
Multi-Directory Listing And Single Directory Listing

How to use this Form:

Use one Form per listing. To reduce "Banner", click on its "UPPER" right arrow.

Send about 100 words to describe your "Professional Profile". See "Fertility Specialists" for examples.

Type in the Form, on screen response, (fill out the blanks). Press "TAB" to move between blank spaces. When finished, please print the Form (Banner will not print with Form): Set your printer to print only one page/black ink.

Preferred payment: Check drawn on an American bank.

Acceptable payment: International Money Order by using your country's currency. Our bank will send the Money Order back to country of origin for collection. The process usually takes about 3-4 weeks.

FEES: Check (X) in appropriate boxes
Select multi-directory or a single directory listings.
Special Rates*: Deadline, December 10, 2000

		Multi-Directory listing in any 3 directories (listed below) for one fee: $395/yr.

Single directory listings: Mark selected directories.

		Arab Family web site $185/yr (Reg. $395/yr)
		Arab Health Directory: $375/yr (Reg. $600/yr)
		World Specialists Directory: $250/yr.
		Advances In Physical Medicine and Rehabilitation: $600/yr (Reg. $1,200/yr)
		Arab Neurosurgery $365/yr (Reg. $600/yr)

Category List:
Check (x) one box of selected categories (below):

		Consultants
		Education & Training Programs
		Educational Material
		Conferences and workshop
		Equipment And Supplies

Supplementary Services:

		Listing under "Arab Patient Information": $180/yr
		Arabic Page Development: $325 (1-3 pages of Arabic text) For samples click Here
		Other Services (attach description/fee of services)

Total Fees - Supplementary Services: $

$ Listing Fee + $ Supplementary Services = $ Total Fees

ORDER INFORMATION:

Name	Title
Special Interest
Department
Institution
Address
City	State/Zip Code Country
Area Code	Telephone number FAX number
E - Mail Address
Web Site Address

Please Print Completed Form And Mail It With Your Payment To:
Doctors' Marketing Service (CI subsidiary)
P.O. Box 748, Lake Forest, California 92630-0748, USA
(949) 472-3767

Back To International Fertility Specialists, click here

Hosted by www.Geocities.ws

		Use one Form per listing. To reduce "Banner", click on its "UPPER" right arrow.
		Send about 100 words to describe your "Professional Profile". See "Fertility Specialists" for examples.
		Type in the Form, on screen response, (fill out the blanks). Press "TAB" to move between blank spaces. When finished, please print the Form (Banner will not print with Form): Set your printer to print only one page/black ink.
		Preferred payment: Check drawn on an American bank.
		Acceptable payment: International Money Order by using your country's currency. Our bank will send the Money Order back to country of origin for collection. The process usually takes about 3-4 weeks.