HERE'S HOW TO ORDER (HDST) Home Dyslexia Screening Test or (DPT) Dyslexia Program Teaching Materials Use your browser's "print" button to print this order form, fill it out and send it in. NAME_________________________________________________________________________   PHONE_____________________________________     FAX______________________________   STREET ADDRESS______________________________________________________________   CITY__________________________________STATE___________________ZIP_____________   COUNTRY if applicable:___________________________________ Fifteen days to preview contents and view first video affords full money back guarantee (less postage). If any internal wrapping seals are broken guarantee is voided.         Number of DPT KITS _____ @    $879.94 ($799.95 each + $43.99 tax + $36.00 shipping)     $_______ (Money Orders only on International orders)       TOTAL ENCLOSED     $_______   FORM OF PAYMENT (check appropriate line) ____ Money Order  Enclosed with order and made payable to Christenson Vision Care ____ Credit Card  #_______________________________ Expiration date_____________   Print name as it appears on card_________________________________   Signature_____________________________________________________         Send Order to: Christenson Vision Care 2215 Vine Street, Suite E Hudson, WI 54016 or CALL 715-381-1234 or FAX 24 hours a day 715-381-5357