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ECMO Specialist Training Manual Third Edition Order Form Name Address City State Zip Country Phone E-mail Manuals 45. 00 ea* For 1 to 5 manuals For 6 or more manuals For shipping and handling Total Prepayment is required prior to shipping. Please make check in U*S* funds drawn on a U*S* bank payable to ELSO or charge to a VISA Discover American Express or MasterCard. Card Exp* Date / Signature ELSO Office 2800 Plymouth Rd Building 300 Room 303 Ann Arbor MI 48109-2800 FAX 734 998-6602 Phone 734 998-6601 E-Mail prycus umich. edu Add 7. 50 shipping and handling for each manual sent within the 48 contiguous states. For other countries Hawaii and Alaska contact the ELSO office for rates. 00 ea* For 1 to 5 manuals For 6 or more manuals For shipping and handling Total Prepayment is required prior to shipping. Please make check in U*S* funds drawn on a U*S* bank payable to ELSO or charge to a VISA Discover American Express or MasterCard. Please make check in U*S* funds drawn on a U*S* bank payable to ELSO or charge to a VISA Discover American Express or MasterCard. Card Exp* Date / Signature ELSO Office 2800 Plymouth Rd Building 300 Room 303 Ann Arbor MI 48109-2800 FAX 734 998-6602 Phone 734 998-6601 E-Mail prycus umich. Card Exp* Date / Signature ELSO Office 2800 Plymouth Rd Building 300 Room 303 Ann Arbor MI 48109-2800 FAX 734 998-6602 Phone 734 998-6601 E-Mail prycus umich. edu Add 7. 50 shipping and handling for each manual sent within the 48 contiguous states. For other countries Hawaii and Alaska contact the ELSO office for rates. 00 ea* For 1 to 5 manuals For 6 or more manuals For shipping and handling Total Prepayment is required prior to shipping. Please make check in U*S* funds drawn on a U*S* bank payable to ELSO or charge to a VISA Discover American Express or MasterCard. Card Exp* Date / Signature ELSO Office 2800 Plymouth Rd Building 300 Room 303 Ann Arbor MI 48109-2800 FAX 734 998-6602 Phone 734 998-6601 E-Mail prycus umich. Please make check in U*S* funds drawn on a U*S* bank payable to ELSO or charge to a VISA Discover American Express or MasterCard. Card Exp* Date / Signature ELSO Office 2800 Plymouth Rd Building 300 Room 303 Ann Arbor MI 48109-2800 FAX 734 998-6602 Phone 734 998-6601 E-Mail prycus umich. edu Add 7. 50 shipping and handling for each manual sent within the 48 contiguous states. For other countries Hawaii and Alaska contact the ELSO office for rates.

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