ABO/AOA Approved Home Study Course Order Form

This page is a printable order form, click print in your browser to print this page. Complete the information then mail or fax in your order to:

California Paraoptometric Section
CE Home Study
2415 K Street
Sacramento, CA 95816
Fax: 916-448-1423
e-mail: paraoptometricsection@coavision.org

CPS Member (Complimentary Member Benefit!)     CPS Non-member ($20 per CE Unit)

Article:         ”Dealing with Angry Patients”     ”Am I Speaking a Foreign Language”         

Please send via:       Mail            Fax           E-mail

____________________________________    _______________________________________
First Name                                                Last Name

______________________________________________________________________________
Street Address

____________________________________________   _______________    _______________
City                                                                    State                     Zip

_________________________________   ____________________________________________
Home Phone                                        Work Phone

_______________________________________________________________________________
E-mail

Payment Method:

Check        Visa          Mastercard

Total Enclosed: _____________

Card No.____ ____ ____ ____-____ ____ ____ ____-____ ____ ____ ____-____ ____ ____ ____ 

Exp. Date: ____/_____

Cardholders Name: _________________________________________________________________

Authorized Sinature: _______________________________________________________________

Our thanks to VWI for their support of the CPS Study@Home Program