Discount Tear Pad Offer VA C C I N E E D U C AT I O N C E N T E R Offer expires 4/30/15 The end of April is busy with National Infant Immunization Week in the U.S. (April 18-25, 2015), World Immunization Week (April 24-30, 2015) and World Meningitis Day (April 24, 2015). To commemorate these events, we are pleased to offer Vaccine Update readers a special offer. Order any tear pad between now and April 30, 2015 using this form at the discounted rate of $2/pad (that’s a 50 percent discount). Offer expires: 4/30/15. • Offer limited to 10 tear pads (total) per person; can be any combination of the items on the form (for example, 10 of one item or several of a few items up to a total of 10). • Orders can be submitted as an attachment to email, by fax or by U.S. mail using this form and must be received by midnight on April 30, 2015. Forms sent by U.S. mail must be postmarked no later than April 30, 2015. To order pads: Most VEC resources are available to download 1. Fax this sheet to the Vaccine Education Center at 215-590-2025. free of charge from our website: 2. Email us at vacinfo@email.chop.edu. (For your protection, please do not include credit card information in your email. Please call the VEC with this information.) vaccine.chop.edu/resources 3. Call us at 215-590-9990. 4. Mail to Attn: Denise Freeman at the address below. For shipping, please include the following information: Informational Tear Pads (50 sheets/pad) Cost Per Pad Quantity Total Cost* Name ____________________________________________ “Facts About Childhood Vaccine: What You Should Know” $2 ___English ___Spanish “Influenza: What You Should Know” $2 ___English ___Spanish City ______________________ State _____ ZIP _________ “Meningococcus: What You Should Know” $2 ___English ___Spanish Phone ____________________ Fax ____________________ “Rotavirus: What You Should Know” $2 ___English ___Spanish Please allow three to four weeks for delivery. “Thimerosal: What You Should Know” $2 ___English ___Spanish For billing, if address differs, please include: “Hepatitis A: What You Should Know” $2 ___English ___Spanish Name __________________________________________ “Human Papillomavirus: What You Should Know” $2 ___English ___Spanish Practice/Company ________________________________ “Pertussis: What You Should Know” $2 ___English ___Spanish “Shingles: What You Should Know” $2 ___English ___Spanish "Too Many Vaccines?: What You Should Know" $2 ___English ___Spanish “Aluminum: What You Should Know” $2 ___English ___Spanish "Vaccine Ingredients: What You Should Know" $2 ___English ___Spanish “Chickenpox: What You Should Know” $2 ___English ___Spanish “Recommended Immunization Schedule: What You Should Know” $2 ___English ___Spanish “Vaccines and Autism: What You Should Know” $2 ___English ___Spanish Practice/Company __________________________________ Street Address ______________________________________ $5 shipping charges will be added for orders placed within the 48 contiguous states. For other locations, Grand Total*: $_______ call for shipping charges. Street Address ____________________________________ City _____________________ State _____ ZIP _________ Phone ___________________ Fax ___________________ q Check or money order payable to CHOP (Mail to Attn: Denise Freeman) q Purchase order # _______ (Mail to Attn: Denise Freeman) q Credit Card ¡ MasterCard ¡ Visa ¡ American Express ¡ Discover Card number: ____________________________________ Expiration date: __________________________________ Name as it appears on credit card: _______________________________________________ Signature: _______________________________________ 3615 CIVIC CENTER BOULEVARD, ARC ROOM 1202, PHILADELPHIA, PA 19104-4399 • PHONE: 215-590-9990 • FAX: 215-590-2025 ©2015 The Children’s Hospital of Philadelphia, All Rights Reserved. 04-15