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Three ways to print the order form:

- Download PDF OrderForm.pdf (Acrobat PDF file)

- Download .JPG OrderForm.jpg (JPG image) [margins under 0.25"]

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Complete, then mail with payment - Thank You!

 
 
Order Form

___ Qty ____________ total Code: OP2e Ophthalmic Photograhy (Each $195.00 US)

___ Qty ____________ total Code: PRP2e Practical Retingal Photograhpy (Each $95.00 US)

___ Qty ____________ total Code: SL3e Slit Lamp: Examination & Photography (Each $86.00 US)

___ Qty ____________ total Code: RB Retina Blues Poster (Each $15.00 US)


___________ Subtotal

___________ Premium Shipping: $13.50 per order (in the United States).

___________ North Carolina residents enter 7% sales tax

___________ International Shipping (Contact us via EMail - Orders@TwinChimney.com)

$ ___________ Total

Check # _____ or money order for $_________ is enclosed
(Remit in U.S. Funds, payable to Twin Chimney Publishing)

VISA / MC (consider online ordering for a quicker order)
VISA /MC # ________ - ________ - ________ - ________

ExpDate ___/___ Security Code (3 digits) from back of card _____

Name on Card ________________________________________

Address of Cardholder __________________________________

City, State ZipCode ____________________________________

Phone number at billing address _______ - _______ - _________

EMail at Address ______________________________________
_____________________________________________________________________

Ship To:

Name :_______________________________________________________

Company :____________________________________________________

Address (No PO Boxes Please):

_____________________________________________________________

_____________________________________________________________

City _______________________ State _____ Zip Code _________________

Country:________

Daytime Phone:________________________

EMail: ________________________

Photographer's name _________________________________________________

_____________________________________________________________________

Print and fill out this form. Mail to:

Twin Chimney Publishing
305 Foster Dairy Road
Mocksville, NC 27028 USA

or EMail the information (Cut & Paste the above) to Orders@TwinChimney.com

The Fine Print

Please pay in U.S. funds and include handling. Twin Chimney Publishing accepts Mastercard, Visa and checks. Twin Chimney Publishing will bill your credit card for books plus shipping.

Shipping Charges:
$13.50/ Premium Ground shipment within the US
$25.00 extra, outside US (for an exact quote: contact Twin Chimney Publishing)

Books are shipped surface (media) mail or UPS Ground. Contact Twin Chimney Publishing concerning costs for Air/Overnight service.

Canadian customers please include 7% GST on books and handling.

30-day Satisfaction Guarantee If for any reason you are not satisfied with the books you ordered, return them in as new condition within 30 days for a full refund. All other returns are subject to a restocking fee.

Prices are subject to change without notice.

Ophthalmic Photography (books)