PAVE - Order Form

Order Form

Order #	Description	Quantity	Price	Cost of order
1250	THE HIDDEN DISABILITY Pamphlet describing P.A.V.E. and symptoms of undetected vision problems		100 for $20.00 1,000 for $160.00	$
6000	P.A.V.E. RESOURCE BOOK 300 informative pages to guide patients and parents (comb bound on Laser paper). Includes: Introduction, Call to Action, Efficacy of VT, Related Health Issues, Research Studies, Vision Articles, Success Stories, P.A.V.E. Resources & Membership, Patient's Guide to Insurance Coverage for Vision Therapy & Summary of Research & Clinical Studies on Optometric VT		$50.00 ea. 2 for $80.00	$
4750	SOME HEROES ARE SMALL Read-together 26 page book for children and adults about learning related vision problems and vision therapy * Postage: (1) $1.50; (5) $3.50; (25) $9.00; (50)12.00		$3.50 ea. + postage *	$
5500	"Vision Alert: 20/20 Is NOT Enough" features parents and students telling experiences before and after vision therapy. The purpose is to raise national awareness of the crucial relationship between vision and achievement and to alert parents, teachers and others about learning related vision problems Tape is VHS for VCR use. (Note that 3/4" U-MATIC tape must be provided to a television station for broadcast purposes- see price list.) Each tape includes a long version (27 minutes and 54 seconds an edited version (15 minutes and 42 seconds) for shorter meetings.		$35.00 ea 10 or more $28.00 ea 3/4" for broadcast $70.00 ea	$
5575	SPEAKER’S VERSION Edited version with a running time of15 minutes and 42 seconds for shorter presentations/meetings.		$35.00 ea	$
Subtotal				$
15% Shipping & Handling ($3.50 minimum)				$
CA Residents only add 7.75% Tax				$
TOTAL Please send payment with this statement. Thank you				$

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___Visa ___ MC #__________________________________ Exp. Date: ____________________

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Please return this form to the address listed below.

For further information concerning the prevention, early detection and correction of learning related vision problems, contact P.A.V.E.®. Members, chapters, and donations support P.A.V.E.®'s mission to make visual health a national priority. Join P.A.V.E.®'s mission today!

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P. A.V.E.® National Headquarters

4135 54th Place, San Diego, CA 92105-2303 * Telephone (619) 287-0081* Toll Free (800) PAVE-988 * FAX (619) 287-0084 * Email info@pavevision.org