ORDER FORM

If you wish to pay by check, please fill out the form, print it, and mail it with payment
to Lexical CE. You may also pay with PayPal or credit card by clicking on the link to each course.

PERSONAL INFORMATION

NAME:

E-MAIL

PHONE NUMBER

ADDRESS:

CITY: STATE: ZIP:

ORDER INFORMATION

CERTIFICATE NO:

ORGANIZATION(S) OBTAINING CREDIT FOR:

and, if applicable,

IF OTHER, PLEASE LIST:

SELECT COURSE(S)

PLEASE CHECK THE COURSE(S) YOU WISH TO PURCHASE.

5 CE Courses
- $95
Latin Words and Phrases - Latin I - $95
- $95
- $95

10 CE Courses
Medical Terminology I - $190
Medical Terminology II - $190
Latin Words and Phrases II - Real Estate - $190
Latin Words and Phrases III - Probate - $190
Financial Terminology - $190
Punctuation - Quotation Marks - $190

Please select the correct total from the drop-down menu.

5-CE Course Total:
- or -
10-CE Course Total:

Please note that in order to guarantee your paperwork is graded by the year-end deadline, there is a $20 surcharge per course if you submit your coursework after December 18 and need it returned to you before the end of the year in time to submit it for credit.

 

PAYMENT INFORMATION

Please make checks payable to Elizabeth Gallo, Lexical CE.

Each 5 CE course costs $95. Each 10 CE course costs $190.

Send Payments to:
Elizabeth Gallo, Lexical CE
792 Grey Rock Road
Norcross, GA 30093

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