Order Form
The Johns Hopkins
Children's Safety Center
Replication Guide
YES! Please send me _____ copies of the
Guide for $50 each, including shipping and
handling.
Only checks and money orders accepted, made
payable to Johns Hopkins University. All
orders must be paid in advance. Proceeds from
the Guide will be used to support the
Johns Hopkins Children's Safety Center.
Please complete all information:
Name:
Title:
Organization:
Address:
City/State/Zip:
Phone Number:
E-mail:
Cost per Guide -- $50.00 :
Number of Guides Ordered :
Total Amount Enclosed :
_______
_______
_______
Mail completed form, along with check or money order, made payable to Johns Hopkins
University to:
Center for Injury Research and Policy
Johns Hopkins Bloomberg School of Public Health
624 N. Broadway, Room 555
Baltimore, MD 21205
(P) 410.614.0225
You may fax the Order Form to 410.614.2797
but the order will not be processed until payment has been received.