You can order the CD-Rom and CME credits kit through the mail.

You will need to print the following order form (print as text only)

ORDER FORM

Name:   _________________________________________

Address:_________________________________________

        _________________________________________ 

City:   _____________________State:____Zip:______

Phone:	(____) __________________________________

CD-ROM (Introductory Price)...............$175.00
CD-ROM (Resident/Fellow Price with letter 
        from Chief of Service)............$125.00
Applicable Sales Tax
       (NY State Orders Only) 8 1/4% .....$______
Shipping and Handling.....................$  5.00
_________________________________________________

                                  TOTAL:  $______

The price includes: CD-ROM, fundus drawing charts,
color pencils and CME credits for purchaser only.

Method of Payment:

___ Check Enclosed 
      (made payable to: The New York 
       Eye and Ear Infirmary)

___ Credit Card (Fill out below)

      (Please check) ___ Visa				 
                     ___ Master Card	 	 
                     ___ American Express 

      Credit Card #  _______________________

      Exp. Date:     _______________________

      Signature:     _______________________

______________________________________________

_______________________________________________