†Shipping & Handling Charges

$4.99 or less. . . . . . . . . . . . . . . . . . . . . $3.50$5.00 – $25.00. . . . . . . . . . . . . . . . . . . $7.50$25.01 – $60.00. . . . . . . . . . . . . . . . . . $9.95$60.01 – $100.00. . . . . . . . . . . . . . . . . $11.50$100.01 – $149.99. . . . . . . . . . . . . . . . $14.95$150.00 and above – add 10% of the subtotal

Orders outside the continental United States: double shipping charges

Pre-Payment by mail: Jim Coleman, Ltd.1500 S. Hicks Rd.,

Suite 400Rolling Meadows, IL 60008

Visa/MasterCard/American Express:

1-866-522-9335Fax: 847-963-8200

Order Online: JimColemanLtd.com/amt

Customer Service: Call: 847-963-8100, or Email:

service@JimColemanLtd.com

Celebrate National Medical Laboratory Professionals Week • April 22–28, 2012

COPYRIGHT INFO: Jim Coleman, Ltd. is the offi cial supplier of Lab Week® merchandise. The Lab Week® logo and theme are copyrighted and cannot be reproduced without permission from Jim Coleman, Ltd. and the ASCP.

SHIP TO: (please print clearly) (Allow 3-4 weeks for regular delivery.)

Name ________________________________________________________________

Institution ____________________________________________________________

Address ______________________________________________________________

City ______________________________________ State _____ Zip ___________

Daytime Phone: (________) ______________________________________________

Fax: (________) _______________________________________________________

E-mail: ____________________________________________________________

METHOD OF PAYMENT: (check one)□ Pre-Payment: make check payable to Jim Coleman, Ltd.□ VISA/MasterCard/American Express fax to 1-847-963-8200,

or online: www. jimcolemanltd.com/amt Card # __________________________________________________ Exp. Date ___________□ PURCHASE ORDERS ($100 minimum) MUST BE FAXED to 847-963-8200. NO PHONED-IN PURCHASE

ORDERS ACCEPTED. 1. Submit a copy of the actual purchase order document with completed Order Form. Purchase

requisitions are not acceptable. 2. The vendor on your purchase order must be Jim Coleman, Ltd. * 3. Purchase orders under the $100 minimum will incur a $5.00 invoicing fee. Please include this charge

as a line item.

Item Quantity Price Total

AMT01 Buttons (Pkg./10)

AMT02 Classic Tee

AMT03 Travel Tumbler

AMT04 Fun Tote

AMT05 Lam. N-W Lunch Bag

AMT06 ID Holder

AMT07a Click Pen

AMT07b Click Pens (Pkg/25)

AMT08 Poster

AMT09 Sponsor Logo Classic Tee

Subtotal __________

9.5% Tax (IL only) ___________

Shipping /Handling† __________

*Invoice Fee ___________

Total ___________

AMT09Sponsor Logo Classic Tee – Features Lab Week sponsors on back of shirt. A wearable work of art in 100% preshrunk cotton, silk screened NMLPW logo. Upgraded 6.1

ounce heavyweight white cotton. S, M, L, XL, XXL (add $3 for each XXL), and XXXL (add $5 for each XXXL) 1-10 $12.49, 11-99 $11.49, 100+ $10.49

AMT02Classic Tee - A wearable work of art in 100% preshrunk cotton, silk screened NMLPW logo. Upgraded 6.1 ounce heavyweight white cotton. S, M, L, XL, XXL (add $3 for each XXL), and XXXL (add $5 for each XXXL) 1-10 $9.99, 11-99 $8.99, 100+ $7.99

AMT07aClick Pen - A work of art on a pen. Full-color design covers entire pen to make a great keepsake. Black ink.

$0.99 each

AMT07bClick Pens (Pkg/25) - A work of art on a pen. Full-color design covers entire pen to make a great keepsake. Black ink.

Pkg/25 $22.95

AMT03Travel Tumbler - Insulated steel outer wall with plastic liner. Stainless steel screw-on lid with slide opening. 16 oz. capacity.1-10 $5.99, 11+ $5.75

AMT04Fun Tote – Fun tote with top zippered closure, side mesh pocket, front pocket and split ring for keys, carabiners, etc. Made of 600D polyester with 26” web handles. 14” x 14” x 5” 1-10 $6.99, 11+ $6.49

AMT01Buttons - Order plenty for your team and for distributing to visitors. Features the NMLPW logo with laminated coating that resists scratching. 1-3/4” x 2-3/4” with rounded edges.Pkg/10 $5.99

AMT05Laminated Non Woven Lunch Bag – Affordable lunch bag features a fully insulated main compartment, fold-over top with Velcro® closure, open front pocket, side

mesh water bottle pocket. Laminated material is water resistant and hand-washable. 9” x 12” x 5.5”1-10 $5.99, 11+ $5.49

AMT06ID Holder - Your team members can keep their IDs close at hand with this upgraded ID holder.

Retractable cord fully extends up to 33” and comes with a swivel alligator clip attachment. Full-color logo protected by epoxy dome for many years of use. Guaranteed for 100,000 pulls.1-10 $2.99, 11+ $2.75

AMT08Poster - Display the Lab Week message proudly in smaller work areas and offi ces. Also makes a great employee giveaway when the celebration is over. 15” x 22” full color poster. $3.99