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Electric Power Publications for Trainers Order Form These prices are through 2003. Prices subject to change without notice. Bill to: Item Organization: Contact Name: Street Address: City, State, Zip: Phone Number: Quantity Pole Climbing Student Manual - $12.50 PC-100 Digger Operation Certification Packet (5 per package) $25.00 per package EAT-102(DO) Aerial Lift Operation Certification Packet (5 per package) $25 per package EAT-103(AL) National Electric Utility Safety Exam - $25 EAT-101 Ship To: Clumsums Illustrated - $15 Organization: Rubber Gloving Training Procedures - $125 ETM-101 Zappy’s Electric Safety Coloring Book EPR-101 (100 per set) - $25 set, (1000 per set) - $220 set Contact Name: Street Address: City, State, Zip: Employee Development Plan - $25 EST-101 Positive-Image Posters Software (No Lost Days) - $25/disk EST-102 Video – How to Sharpen Auger Bits- $25 Safety Handbook for Line Workers $19 Up to $25.00 $25.01 - $$50.00 ADD $ 5.00 $ 7.50 $50.01 - $100.00 $100.00 and up $10.00 $15.00 FOR ORDERS TOTALING Phone Number: Total Wooden Pole Climbing Certification Packet (5 per package) $25 per package EAT-PC-103 Administrator’s Guide for Wooden Poles Climbing Certification - $9.50 ETM-PC-101 Return this Order Form: Mail: Publications Engineering, Utilities and Public Works Training Institute 301 Tarrow, TEEX Suite 119 College Station, TX 77840-7896 FAX: Subtotal Tax 8.25% $ If tax exempt, provide Fed Tax #_______________ Shipping and Handling See chart at left Total 979-458-6771 Phone: 979-845-6563 Customer Purchase Agreement Arrange payment by one of the following methods: 1. 2. 3. Check enclosed – Payment to TEEX Purchase Order – Copy of official company PO must be attached I certify that I have authority to commit my company’s funds to pay for this purchase ____________________________________ _________________________ (Signature authorizing payment) 4. Credit Card (Printed name) Mastercard Visa ______________ (Title) American Express Card # _________________________________________ Expires:____/_____ Name on Card:________________________________ Signature:__________________________________ If you select method #2 or #3, you will receive an invoice from TEEX PS-101 Electric (7/19/02) Publication Sales 979-845-6563 FAX: 979-458-6771