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    Order Form

    Audio, DVD and Video Purchase 
    Tape Title

    Audio       DVD      

    Video
    ____________________________________________________ _________ _________ _________  
    ____________________________________________________ _________ _________ _________
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    Price Subtotal:
    __________

    Shipping and Handling

    US Priority Mail    
    Federal Express  Please call us for exact rates.
    United States:
    10% of total order
     
    United States:
    $ 25.00+
    Canada and Mexico:
    15% of total order
       
    Canada and Mexico:
    $ 35.00+
    Outside North America:
    Fed Ex only
       
    Outside North America:
    $ 50.00+
             
    Please allow two weeks delivery.  
    Shipping and Handling:_______________________
         
       
    TOTAL AMOUNT DUE:______________________

     
    Payment
    Payment is due with the order. Please pay by check or credit card. Outside the US, credit card only, please. Make checks payable to The Bowen Center.
     
    Type of card (please circle):Visa / Mastercard
     
      _______________________________________ ___________________________
      Credit Card Number Expiration Date Signature
    Bill to:
    Name:
    _________________________________________________________________________
    Organization:
    _________________________________________________________________________
    Address:

    _________________________________________________________________________

    City, State, Zip, Country:
    _________________________________________________________________________
    Daytime Phone:
    _________________________________________________________________________
    E-mail:
    _________________________________________________________________________

    Check if mailing address is same as billing address
    Send to:
    Name:
    _________________________________________________________________________
    Organization:
    _________________________________________________________________________
    Address:

    _________________________________________________________________________

    City, State, Zip, Country:
    _________________________________________________________________________
    Daytime Phone:
    _________________________________________________________________________
    E-mail:
    _________________________________________________________________________

    If you have questions about your order, please contact Kathy Vlahos @ 202-965-4400 x 23 or kvlahos@thebowencenter.org



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