One set of DVD’s     .........................................................................

$600.00

CA Residence include 7.5% sales tax     ............................................

$43.50

San Diego Residence include  7.75% sales tax     ...............................

$46.50

Shipping U.S. (except Alaska, Hawaii & Puerto Rico)     ...................

$25.00

Shipping to: Alaska, Hawaii & Puerto Rico     ....................................

$100.00

Shipping outside U.S     .....................................................................

$100.00

Total .......................................................................................................

$ ______

Check enclosed payable to:  San Diego Shoulder Institute

Please bill me

Please charge this to my       Visa           Master Card

Please Print

Name:

_______________________________________________________

Address:

_______________________________________________________

City:

_______________________________________________________

State:

_______________________________________________________

Zip Code:

_______________________________________________________

Country:

_______________________________________________________

Phone:

(________)__________________________

Fax:

(________)__________________________

Email:

_______________________________________________________