ORDER FORM

Continuing Pharmacy Education

Print this form and mail to:

W-F Professional Associates, Inc.
400 Lake Cook Road • Suite 207 • Deerfield, Illinois 60015 
800-323-4305 • 847-945-8050

Or FAX to
847-945-5037

Please enter my one year's enrollment to CE PRN®. 

Enclosed is $110.00

Name

Pharmacy Name (Optional)

Address

City                                                       State          Zip

Home Phone

Work Phone

Email Address

Account Number                                                    Expiration Date

Print this form and mail to:

W-F Professional Associates, Inc.
400 Lake Cook Road • Suite 207 • Deerfield, Illinois 60015 
847-945-8050

Or FAX to
847-945-5037

or Email info@wfprofessional.com