PBR Group Purchase | Individual Pediatric Resident Information

First Name*

Last Name*

Email Address*

Please be sure to enter your NON residency email address. This will be used as your username and the email address will be used to communicate with you after you graduate.

If you have ever given us a different email address, please type that below.

We want to limit the number of emails you get. Two different email addresses could mean that you'll get too many emails from us. Some for members and some for non-members. Please help us avoid that by typing in any alternate email address that you may have so that we can remove your other email address(es) from our database.

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Date

What is your PGY Level?*

Which of the following describes you best?*

When will you take your ABP Initial Certification Exam?*

The exam is usually in October of the year that you graduate from pediatric residency.

When would you like to activate your membership?*

Our digital resources are usually active for one year. If you're taking the exam next year and your access will expire before your exam, please consider one of the options below.

I want my membership activated NOW and I DO NOT NEED a discounted extension.
I want my membership activated NOW and I DO NEED a discounted extension.
I want my membership activated LATER on NOVEMBER 1st of this year.

How many months of additional access do you need?*

Please enter a number from 1 to 12.

Who is the main person coordinating this group purchase?*

What is the name of your residency program or institution?*

In what city and state is your residency program?*

About how many people are participating in this group order?*

What is the approximate size of each class at your program?*

Will your enrollment come with any hardcopy books that require shipping?*

Yes. My order will include hardcopy books.
No. My order will not include hardcopy books.
I have no idea.

Is the enrollment fee for your personal membership greater than $495?*

Yes. My membership will be greater than or equal to $495.
No. My membership will be less than $495.

You have shipping options!*

If someone is helping to coordinate your group purchase, and each individual's membership is greater than or equal to $495, we'll ship all of the books to one address for free. But, you may choose to pay $25 extra in order to have your books shipped directly to you. Which option do you prefer?

Free shipping to our group purchase coordinator
Ship directly to me. I authorize a $25 charge for shipping directly to me.

You have shipping options!*

For group orders, we'll usually ship all of the books to one address for $15. But, you may choose to pay $25 in order to have your books shipped directly to you. Which option do you prefer?

I authorize $15 to be charged for shipping to our group purchase coordinator.
I authorize a $25 charge for shipping directly to me.

What is the address that you would like have your books shipped to?*

Street Address Address Line 2 City State ZIP Code

What is the name of the resource(s) that you and your peers are signing up for?*

If you don't remember, CLICK HERE. A new window will open up in order to help refresh your memory of the different options.

How much are we authorized to charge your credit card?*

Please input the amount that you believe you will be charged for your portion of the group order. If there are any shipping charges that you are aware of, please add those into your calculation.

Do you want a payment plan?*

Please note that payment plans come with an added payment plan fee of $20 per payment.

No. I would like to have my payment taken in full.
Yes. I want 4 monthly payments and I understand that $20 will be added to each payment.
Yes. I want 8 monthly payments and I understand that $20 will be added to each payment.

Credit Card Authorization*

I agree to allow Pediatrics Board Review Inc. to charge the credit card submitted on the previous page for this purchase.

I agree to the statement above and allow Pediatrics Board Review Inc. to charge my credit card for this purchase.

If there's anything else you'd like for us to know, please type it in the box below.

For example, if you put the wrong email address on the previous page, you can let us know that here. If you have a question about something above and would like to give us a "yes/no" type of question that we can answer before processing your order, then please type that question/clarification below

Terms & Conditions*

I have been provided with PBR's Terms & Conditions and I agree with them.

I agree with the statement above regarding PBR's Terms and Conditions.

Consent to receive emails*

I agree to allow Pediatrics Board Review Inc. to email me regarding my orders, content updates and other miscellaneous updates. I understand that Pediatrics Board Review Inc. does not sell or otherwise share subscribers' contact information with any affiliate companies.

I agree to the statement above. It's okay for PBR to email me.

Security statement*

Pediatrics Board Review Inc. resources are meant for individual use and are not to be shared. This includes, but is not limited to, the sharing of usernames, passwords, downloadable resources, streaming resources, and the sharing of test-taking strategies taught through through the various test-taking strategy courses. Pediatrics Board Review Inc. uses security measures to track usage and to detect account sharing in order to prevent theft and fraud. Cookies are also used on our websites. If fraudulent activity is detected, related accounts will be cancelled, no refunds will be issued and violators will be prosecuted to the fullest extent of the law.

I agree to the statement above regarding security measures to prevent internet theft.

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[FOR INTERNAL USE] Is this a part of a residency group purchase?*

Yes

Just A Little More Info!

Thanks for filling out your payment information on the previous page. We can only offer group purchases with credit cards. If you filled out the form with your PayPal account, please fill out the form with your credit card by clicking here.