SUNY Order Form — OPTOPALS

SUNY Notebook Order Form

We hope you guys are loving it so far!

NOTE: The sale is for the ORIGINAL version of the book. There is a new version on Amazon Prime with reference sheets in the beginning and more blank pages at the end for your own notes. If you want the new version, go to “Shop” above which will re-direct you to Amazon.

Name

First Name

Last Name

Phone

(###)

###

####

Notebook color:

Pink

Blue

Black

Beige

Surprise me

Any other details?

If you would like more than one notebook, please indicate amount and what colors here.

How would you like to receive your notebooks?

How would you like to pay for the notebook?

TOTAL: $8.46 $12.95 for original Optometry Clinic Notebook -$5.18 (40% DISCOUNT) $0.69 NYS tax (8.875%)

Would you like a receipt?