Salud Manual Order Form
Exit this survey

ORDER FORM FOR 5TH EDITION OF THE BERNALILLO COUNTY SALUD MANUALS

Please complete this form to reserve your copies of the Bernalillo County Salud Manual. We will hold manuals for up 7 days for pick-up. If you need to make other arrangements to meet your organization's needs please call us.

Please call 319-8683 for information about mailing manuals. We can mail up to 10 for the cost of postage.

If your organization needs an invoice, we will process your invoice within the next 2 days.

Checks should be made out to HELP-NM (the My Community NM fiscal agent).

Please email admin@mycommunitynm.org if you have any questions or to make arrangements to pick up manuals.

Please mail your check to:

HELP-NM
My Community NM project
5101 Copper NE
Albuquerque NM 87108

PLEASE PRINT A COPY OF THE FORM BEFORE YOU CLICK NEXT AND INCLUDE IT WITH YOUR CHECK

*
1. The manual/s will go to:

The manual/s will go to: Name:
Organization:
Address:
Address 2:
City/Town:
State:
ZIP:
Email Address:
Phone Number:

*
2. How many manuals would you like to order? ($3.50/manual)

How many manuals would you like to order? ($3.50/manual)

3. How would you like to receive the manuals?

How would you like to receive the manuals? I will pick up the manual/s at HELP-NM (5101 Copper NE Albuquerque 87108).

I want one manual mailed to me ($4.95 total).

I want between 2-10 manuals mailed to me ($10.95 for 2-10 copies). NOTE: Orders over 10 manuals require pick up.

*
4. How will you pay for this order?

How will you pay for this order? Check

Purchase Order

Cash (cash is only accepted in certain cases)

Other

5. Is your contact information the same as above?

Is your contact information the same as above? Yes

Salud Manual Order FormExit this survey