Order Form PLEASE RETURN WITH YOUR REMITTANCE OR PURCHASE ORDER

Please send us the following loose-leaf books:

QTY   (price is for initial loose-leaf service plus one year update service)
____    Book B (Adjudication) - $110.00
____    Book C (Schedule for Rating Disabilities) - $90.00

____    Book A (General) - $250.00
____    Book D (Insurance/Compensation/Fiduciary) - $80.00
____    Book G (Vocational Rehabilitation and Education) - $250.00
____    Book H (Loan Guaranty) - $100.00
____    Book I (Medical) - $140.00

Please send the loose-leaf book(s) and all supplements to the following address:*

Office: ___________________________________________________________
Attention: _________________________________________________________
Address: _________________________________________________________
                   _______________________________________________________
City: ________________________   State: _________  Zip: _________________
Email: ________________________________________
Phone: ____________________________  Fax: ___________________________

Referred by: ____________________________________________________________________

Remittance is being made in the following form:

(  )  Check (enclosed)     (  ) Purchase Order

Or, use Paypal for your entire purchase:

	NEW ORDER	RENEWAL
BOOK A
BOOK B
BOOK C
BOOKS B&C
BOOK DEF
BOOK G
BOOK H
BOOK I
ALL 7 BOOKS

Note: We do not accept VISA, MASTERCARD, or other charge cards.   This saves you money, since we would have to charge a higher price to cover the costs associated with a merchant credit card account.

* If you are ordering multiple copies, and wish the books or the updates sent directly to a specific address, just attach a distribution list to your order form.

Jonathan Publishing
660 Laurel Street, Ste B-103
Baton Rouge  LA  70802

Fax: 702-993-6003