MUE Manual Order Form
Mue Manaul plus CD-ROM (Includes MUE Primer and MUE 2005 Quarterly Updates) MUE 2005 Quarterly Updates Only MUE Primer Only				$149.95 $ 79.95 $ 29.95
__________________________________________________________________ NAME __________________________________________________________________ TITLE __________________________________________________________________ ORGANIZATION __________________________________________________________________ ADDRESS __________________________________________________________________ CITY/STATE/ZIP CODE __________________________________________________________________ PHONE/FAX __________________________________________________________________ E-MAIL
MUE MANUAL plus CD-Rom (Includes MUE Primer & MUE 2005 Quarterly Updates) Shipping (Qty is the No. of MUE Manuals Ordered) MUE 2005 Quarterly Updates Only (Free Shipping) MUE Primer Only (Free Shipping)	QTY _____ _____ _____ _____	X X X X	COST $149.95 $10.00 TOTAL $79.95 $29.95 TOTAL	TOTAL ________ ________ ________ ________ ________ ________
Mail your check or fax your order to: Insight Therapeutics, LLC 740 Duke Street, Suite 120 Norfolk, VA 23510 Phone: 757/625-6040 Fax: 757-625-4538	Payment Options ___Check  ___Purchase Order _______________________________________________ Purchase Order No.