Online Store

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Order Form
Quantity _____ Subtotal ___________
| Audio, DVD and Video
Purchase |
| Tape Title |
Audio DVD
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Video
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| ____________________________________________________ |
_________ |
_________ |
_________ |
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| ____________________________________________________ |
_________ |
_________ |
_________ |
| ____________________________________________________ |
_________ |
_________ |
_________ |
| ____________________________________________________ |
_________ |
_________ |
_________ |
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_________ |
_________ |
_________ |
| ____________________________________________________ |
_________ |
_________ |
_________ |
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Price Subtotal:
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__________ |
| Video Rental (Please
complete this section and sign rental agreement if you are renting videos) |
| Video Title |
Show Date |
Fee |
| ____________________________________________________ |
__________________ |
_______________________ |
| ____________________________________________________ |
__________________ |
_______________________ |
| ____________________________________________________ |
__________________ |
_______________________ |
| ____________________________________________________ |
__________________ |
_______________________ |
| ____________________________________________________ |
__________________ |
_______________________ |
| ____________________________________________________ |
__________________ |
_______________________ |
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Subtotal:
|
_______________________ |
Rental Agreement
To keep rental and purchase prices as reasonable as possible, it
is the Family Centers policy not to permit previewing, since
each use of the video shortens its life. However, if you are planning
to purchase a video, you may pay the rental fee for the video to preview
it. The rental fee will be deducted from the purchase price if you
decide to buy the video. Clinical videos may only be rented.
Please order at least three weeks prior to the desired showing
date.
This rental agreement must be signed and returned to the Bowen
Center before videos will be released. Please fax to (202) 965-1765.
- Clinical videos will be shown only to professional audiences
and the confidentiality of the families on the tapes will be protected.
- Videos will not be reproduced in any manner (including sound
track reproduction). The Family Center videos are copyrighted.
Any reproduction of material in them is a violation of copyright
law.
- Videos will be played on machines in good working condition so
they will not be damaged.
- Videos will be used for one showing only, and will be returned
promptly after use, insured for $200.
I agree to the above rental terms. Signature:_______________________________________
Date:___________________
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Shipping and Handling
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| US Priority Mail |
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Federal Express Please
call us for exact rates. |
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United States:
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10% of total order
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United States:
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$ 25.00+ |
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Canada and Mexico:
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15% of total order
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Canada and Mexico:
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$ 35.00+ |
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Outside North America:
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Fed Ex only
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Outside North America:
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$ 50.00+ |
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| Please allow two weeks delivery. |
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Shipping and Handling:_______________________
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TOTAL AMOUNT DUE:______________________
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| 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. |
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| Type of card (please circle): |
Visa / Mastercard |
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___________________________ | ____________ |
___________________________ |
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Credit Card Number | Expiration Date |
Signature |
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Bill to:
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Name:
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_________________________________________________________________________
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Organization:
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_________________________________________________________________________
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Address:
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_________________________________________________________________________
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City, State, Zip, Country:
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_________________________________________________________________________
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Daytime Phone:
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_________________________________________________________________________
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E-mail:
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_________________________________________________________________________
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Send to:
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Name:
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_________________________________________________________________________
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Organization:
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_________________________________________________________________________
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Address:
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_________________________________________________________________________
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City, State, Zip, Country:
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_________________________________________________________________________
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Daytime Phone:
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_________________________________________________________________________
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E-mail:
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_________________________________________________________________________
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If you have questions about your order, please contact Kathy Vlahos @ 202-965-4400 x 23 or kvlahos@thebowencenter.org
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