School/Student Organization Information

School/Student Organization Name:

School Address:

City, State, Zip:

Incoming Class Size: Total Program Size:

Dealer Information

Dealer Name: Rep Name:

Rep City and State: Rep Phone:

School Sale Coordinator/Faculty Advisor (Stethoscopes will be shipped directly to this person)

Contact Name: Phone:

Title: E-mail:

Shipping Address:

Shipping City, State, Zip:

Program Information3M’s School Sales Program offers schools and student organizations the opportunity to earn free stethoscopes through sales coordinated with a Littmann stethoscope dealer. The free Littmann stethoscopes will be donated to the school or student organization directly by 3M.

Sale Summary

Date of Sale:

Stethoscope Model Quantity Purchased Stethoscope Model Quantity Purchased

Select Master Cardiology™

Lightweight II S.E. Cardiology S.T.C.

Classic II S.E.* Cardiology III™*

Master Classic II™ Model 3100 Electronic

Classic III™* Model 3200 Electronic

Classic II Pediatric Teaching Master Classic II™

Classic II Infant Teaching Classic II S.E.

3M™ Littmann® Stethoscope School Sales Program Redemption Form

*Purchase of select models receive a free accessory kit

Black eartips Gray eartips

Number of Tips and Tags Number of Accessory Kits

Black Tips/Tags Classic II S.E. Black Classic III

Gray Tips/Tags Classic II S.E. Gray Cardiology III

Credit Calculation

Total Stethoscopes Purchased: Total Redemption Credits Available: (stethoscopes purchased ÷ 10 = credits)

Allow two weeks for delivery after form is received by your 3M Littmann School Promotion Program Coordinator. The program only applies to the following schools in the continental United States, Hawaii, Alaska, Puerto Rico and the US Virgin Islands (“Territory”): Chiropractic, EMT, Nursing, Pharmacy Tech, Physician Assistant, Physical Therapy, Respiratory Therapy, Veterinary and Veterinary Tech.

Redemption InformationEvery ten stethoscopes purchased as part of a coordinated sale earn one credit* toward the donation of free stethoscopes. See the chart to the right for details.

Free I.D. tag and eartip set with every stethoscope purchased through the school sale. Free accessory kit with the purchase of a Classic II S.E., Classic III or Cardiology III stethoscope.

E-mail, fax or mail completed form to:

Littmann School Promotion Program Coordinator 1111 East South River Street, Appleton, WI 54915Email: littmann@mmmtsales.comPhone: 800-413-1795 Fax: 920-993-4977

3M, Littmann, Master Cardiology, Cardiology III, Classic III, Master Classic II, the Littmann Quality seal, and the L are trademarks of 3M, used under license in Canada. 70-2011-5731-3

Please recycle. Printed in USA. © 3M 2015. All rights reserved.

3M Health Care3M Infection Prevention Division 2510 Conway Ave., St. Paul, MN 55144 USA

1-800-228-3957 | www.littmann.com

Redemption Details (Credits cannot be redeemed for Electronic Stethoscopes)

Model QuantityCredits Required

Credits Redeemed Tubing Color/Chestpiece Finish

Lightweight/Classic

Select 1

Lightweight II S.E. 1

Classic II S.E. 1

Master Classic II™ 1

Classic III™ 1

Classic II Pediatric 1

Classic II Infant 1

Cardiology/Teaching

Cardiology III™ 2

Master Cardiology™ 2

Cardiology S.T.C. 2

Teaching Master Classic II™ 2

Teaching Classic II S.E. 2

* Credits have no monetary value and cannot be redeemed for anything outside the school sales program. Credits cannot be transferred, assigned, saved, carried over, or combined with other sales event credits earned by a school or student organization for use by that or any other school or student organization. Credits cannot be redeemed for Electronic Stethoscopes. Credits must be redeemed within 45 days of the sale date using the official school sales redemption form or they will be considered expired. This form may be submitted by either the school sale coordinator or the dealer representative. The donated stethoscopes will be shipped directly to the school sale coordinator.

EARN REDEEM

EARN 1 CREDIT

for every ten (10) stethoscopes purchased as part of the sale.

REDEEM 1 CREDIT

to get a Lightweight or Classic stethoscope donated to the school or student organization.

REDEEM 2 CREDITS

to get a Cardiology or Teaching stethoscope donated to the school or student organization.

Littmann®

Stethoscopes