FALL 2015 UNECOM M E D I C A L E q U I P M E N T S T U D E N T O R D E R F O R M

Students Mailing Address:

Name: ____________________________________________________________________________________________________

Address: __________________________________________________________________________________________________

City: ____________________________________________________ State: ______________ Zip: _____________________

Phone (Day): ______________________________________________________________________________________________

Email: ____________________________________________________________________________________________________

University of New England Bookstore

11 Hills Beach Road Biddeford, ME 04005

207-282-3025 Fax: 207-282-3346 e-mail: cheryl-woolley@une.edu

Please fill out this order form and mail along with payment to: University of New England Bookstore

11 Hills Beach Road

Biddeford, ME 04005

Method of Payment

Check / Money Order MC VISA Am. Ex. Discover

(Payable to: University of New England Bookstore)

Card # :_________________________________________________________ Expiration Date: _________________________

Billing Zip Code: _________________________________ 3 Digit Security Code: ____________________________________

Printed Name ___________________________________________ Signature _____________________________________________

Complete Kit Contents:

Special Kit Price: $968.44

Littmann Cardiology III Stethoscope Black 27"

McCoy Accura Sphygmomanometer Black

McCoy Tuning Fork C512 Frequency

McCoyTuning Fork C128 Frequency

McCoy Orange Taylor Percussion Hammer

Professional Case Multi Pocket Medical Bag Black

Pocket Eye Chart

Welch Allyn Diagnostic Kit

Exam Gown