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SPINAL CORD INJURY
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Minimum Order $5 -
No Partial Payments
Please print this form and mail it to SCINI at:
3911 Princeton Drive,
Santa Rosa, CA 95405-7013
Business Hours: Monday-Thursday,
9:00 a.m-4:00 p.m.
Toll-free: 1-800-548-CORD
(1-800-548-2673)
Phone: 1-707-577-8796;
FAX: 1-707-577-0605
e-mail: spinal@sonic.net
Name: ____________________________________________________________
Title: _____________________________________________________________
Organization: _______________________________________________________
Street: ____________________________________________________________
Apartment Number: ____________
City/State/Zip: ______________________________________________________
Phone: _____________________________________________________________
____ Information on Membership in SCINI
____ Information on Membership in SCINI's
Video Lending Library
Information Sheet(s): ($5/apiece)
_____ #1 Male Sexuality
_____ #2
Female Sexuality (includes pregnancy)
_____ #3
Medical Research
_____ #4 Rehabilitation Facilities
_____ #5 Bladder Management
_____ #6
Bowel Care
_____ #7
Colostomy
_____ #8 Suprapubic Catheters
_____ #9
SCI World Wide Resources (HTML file containing 150 listings in 30 categories)
_____ #10
SCI Statistics/Economics
Topic of my choice:
Video Lending Library Members: Video # _____
Journal Article from SCINI's Information Center ($2/apiece):
Total Cost: ________
Please include check
payable to SCINI.
Any questions? Contact us at: spinal@sonic.net