IAPS Mail-In Order Form

Last Name, First Name:

Telephone Number: 

Mailing Address:

E-mail Address: 

IAPS Courses:

Payment:

Check or Money Order

VISA

MASTERCARD

Credit Card Number: 

Total Amount to be Billed:

           *Please include $10 shipping/handling per course plus 8.25% sales tax if CA resident. Full refund minus postage if all materials are returned undamaged and unused within 10 days of receipt.

Mail Order Form To:

The Institute of Advanced Psychological Studies

32129 Lindero Canyon Road, Suite 201

Westlake Village, CA 91361