Order Form

Please print this form, fill it out, and mail it with your check or money order to:

Ohio Center for Sport Psychology
21625 Chagrin Blvd., Suite 200,
Beachwood, OH, 44122.

How many	Item	Unit Price	Sub-Total
________	Developing Sport Psychology Within Your Clinical Practice PDF file on CD	$25	________
________	Quotation Collection: The Nine Mental Skills of Successful Athletes	$12	________
________	Nine Mental Skills Measurement Kit CD	$25	________
________	Baseball Cap with logo Black hat, white logo & lettering	$20	________
________	Baseball Cap with logo Khaki hat with black logo & lettering	$20	________

Merchandise Total	________
Shipping & Handling	________
Total Due	________

Shipping and handling charges

First item . . . . $3.00
Each additional item add . . . . $1.00

Name __________________________________

Address _________________________________

________________________________________

Phone____________________

Email ____________________

You may charge your order to a VISA, Discovery, or MasterCard issued from a U.S. bank. If you wish do do so, please provide the following information:

Circle one: VISA Discovery MasterCard

Name as it appears on your card ________________________

Billing Address

Card Number ________________________________________

CVV Number ____________ (last three digits on back of card)

Expiration Date ______________________________________

Your signature authorizing this charge ____________________

Amount to be charged _________________________

Charges will appear on your credit card statement as ProfessionalCharges.com