Members Mailing List Rental Application

In order to obtain the AAWC mailing list, you must complete the rental application and return it with your payment, along with a sample of the materials you will be sending to our members. The AAWC will review your application and if approved, peel and stick labels in ZIPCODE order will be sent to you within 4 to 6 weeks of application. See terms for RUSH orders below. If your application is not approved, your application, payment and materials will be returned to you with an explanation.

PRICE SCHEDULE
 for one time use
 approximate number of names: 1600
AAWC MEMBER PRICES NON-MEMBER PRICES
>> complete set of peel and stick labels for a single use. If you are a member of AAWC:
$100.00
>> complete set of peel and stick labels for a single use. If you are not a member of AAWC:
$200.00
>> special requests or RUSH orders an additional $25.00 >> special requests or RUSH orders an additional $50.00

TERMS FOR RUSH ORDERS: RUSH orders can be requested and will be made after a copy of the materials to be mailed to members is reviewed and approved by the AAWC. Please make sure to include the additional “Special Request” fee listed above. RUSH orders will be sent within 5-7 business days as opposed to the standard 4-6 week delivery.

*The AAWC Mailing List is the property of the Association for the Advancement of Wound Care and may not be used without appropriate rental per the terms of this agreement. The Mailing List is only provided on peel and stick labels for one time use. Additional mailings of the same or different type require an additional application and/or fee.


Print this page, mail or fax the completed form to:
AAWC
83 General Warren Boulevard
Suite 100
Malvern, PA 19355
Fax: 610-560-0502
Phone: 800-237-7285, ext. 223

AAWC MEMBERS MAILING LIST RENTAL APPLICATION

-Single Use-
-One Use per Application-


I. PLEASE TYPE OR PRINT CLEARLY.
Brief description of intended use (you must also include a copy of the materials you will be sending our members):

Applicant’s Name: ____________________________________ Phone: ____________________________

Address: ______________________________________________________________________________

City: _____________________State: ______Zip: _________ Email:_______________________________


II. PAYMENT MUST ACCOMPANY REQUEST. (If not approved, your payment will be returned.)

>>AAWC Members $100.00 ______________

>>Non-Members $200.00 ______________

Additional Costs for Special Requests (for example, special coding on labels, RUSH orders)

>>AAWC Member $25.00 ______________

>>Non-Member $50.00 ______________

Briefly describe special request:

_____________________________________________________________________________________

Total enclosed:______________

Payment Method: _ Check _ Visa _ MC _ AMEX

Credit Card Number (if applicable):______________________Expires:________

Signature:___________________________________


III. PLEASE READ AND SIGN BELOW:

I understand that, if approved, the AAWC mailing list is only provided on peel and stick labels in ZIP-CODE order and is for one-time use only. I understand that additional maillings of any type would require a separate application and/or fee.

Signed_________________________ Print Name:_____________________________

Send your check or money order payable to the AAWC or include your credit card information with this application. Please include a sample of the materials you will be sending to our members.

PAYMENT MUST ACCOMPANY REQUEST. No Purchase Orders.

AAWC
83 General Warren Boulevard
Suite 100
Malvern, PA 19355
Fax: 610-560-0502
Phone: 800-237-7285, ext. 223