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Organization Name: Student Name:
(The student name will appear on your certificate as written on this order form. No credentials will appear on certificate.)
Mailing Address:
City: State: Zip:
Contact Number: Fax Number: Email Address:
  xxx-xxx-xxxx   xxx-xxx-xxxx    
Payment Type: Credit Card Check (Make checks payable to "Board of Regents")
You will be redirected to Authorize.net to complete your payment
Mail To: ATTN: Distance Learning Coordinator
University of Nevada, Reno/CASAT
800 Haskell, First Floor
Reno, NV 89509
Fees do not include textbook
Product Format Amount Contact Hours Quantity
Substance Abuse Prevention* Hard Copy $144 18
Environmental Prevention Strategies* CDRom $75 8
Cultural Communities Hard Copy $48 6
Cultural Communities Hard Copy $160 20
Ethical Decision Making in Substance Abuse Prevention (Ethics) Hard Copy $64 8
Creative Leadership Hard Copy $64 8
Socioeconomics and Prevention* Hard Copy $48 6
Socioeconomics and Prevention* Hard Copy $80 10
Methamphetamine Prevention: An Inquiry Hard Copy
and
Resource CDRom
$85 10
Methamphetamine Prevention: An Inquiry Hard Copy
and
Resource CDRom
$135 16
Additional Materials
Gift Certificate n/a $ n/a
Substance Abuse Prevention Textbook $60 n/a
Cultural Communities Textbook $20 n/a
Creative Leadership Textbook $25 n/a
Socioeconomics and Prevention Textbook $20 n/a
Order Total: $0
How did you hear about continuing
education at CASAT?
Internet
Ad (Where?)
Colleague
Addictioned.org
CASAT Website
Other
Notes:
* Visit the CASAT website to enroll in self-paced online distance learning at: http://selfpaced.casat.org.
If reporting contact hours to the Board of Examiners for Social Workers in Nevada, homework is to be submitted to CASAT for approval 60 days after delivery. Please contact Julie Tieman for more information about adjustments to products specific to Nevada social workers.
Prevention Distance Learning Guarantee and Refund Policy: If content or format is other than satisfactory, CASAT will provide a full refund for purchased materials that are returned in unused condition within 30 days of original postmark. CASAT refund policies can be found at www.casat.org.