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	ORDER FORM	How It Evolved: Dentistry's pursuit for excellence Revised Edition By Richard A. Glenner, DDS 81/2 by 11 format, illustrated, softbound, and CD-ROM An account discussing the evolution of equipment, instruments, supplies and techniques used in dental offices. This illustrated volume is the companion to the author's previously published book, THE DENTAL OFFICE. To order, please complete this form and send with payment to: PIERRE FAUCHARD ACADEMY P.O. Box 80330 LAS VEGAS, NV 89180-0330 Please pay in advance (international Money Order or Check) in the amount of US$ $30.00 (includes shipping and handling) Please allow 4 - 6 weeks for delivery U.S. currency only. Please do not send cash. Make checks payable to PIERRE FAUCHARD ACADEMY Number of copies of HOW IT EVOLVED: _____________x US$ $30.00 Amount of Order : US$ ________________________ Orderer: ________________________________________________________ ...................DR. Mr. Mrs. Miss. Ms. SHIP TO:________________________________________________________ Mailing Address__________________________________________________ Mailing Address__________________________________________________ City_________________________State______________Zip Code__________ Country_____________________________ Your Daytime Phone Number:________________________________________ FAX Number:_____________________________________________________ Payment Amount Enclosed — Money Order or Check: USD $ __________ Thank You!