If
you'd like a printed copy of the HOT Careers in CT booklet, we'd
be happy to send it to you. Currently, we can't accept online
orders, but you can fill out this form, print it, and mail/fax
it to the address below.
H.O.T.
Careers in Connecticut
Health Occupations and Technology
Second Edition 2003-2005
Order Form
Form of Payment
Cash
Check (Payable to Northwestern CT AHEC) Check Number:
Purchase Order #: _______________
For Tax Exempt Organizations
Tax exempt Identification #: _______________________
**To receive tax exempt status - please attach a copy of tax exempt
certificate**
Please send the following:
1) Order Form
2) Purchase Order, Check or Cash
3) Tax Exempt Certificate (if applicable)
to:
Northwestern CT AHEC, Inc.
530 Middlebury Road
Suite 212B
Middlebury, CT 06762
Please indicate if
you are picking up your HOT guide(s) from your regional AHEC office
or if you prefer to have the HOT Guides mailed to you
Pick up HOT Guide(s)
from regional office________________
Indicate which office________________
Mail HOT Guide(s) ________________
Regional
Office Locations:
Connecticut
AHEC Program
263 Farmington Avenue, MC 2928
Farmington, CT 06030-2928
860.679.7968 (voice)
860.679.1101 (fax)
Shannon Kelmelis
e-mail: kelmeliscuchc.edu
nwctahec.org