Online Store

Order Form

Quantity _____ Subtotal ___________

Audio, DVD and Video Purchase
Tape Title	Audio       DVD		Video
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	Price Subtotal:		__________

Video Rental  (Please complete this section and sign rental agreement if you are renting videos)
Video Title		Show Date	Fee
____________________________________________________		__________________	_______________________
____________________________________________________		__________________	_______________________
____________________________________________________		__________________	_______________________
____________________________________________________		__________________	_______________________
____________________________________________________		__________________	_______________________
____________________________________________________		__________________	_______________________
		Subtotal:	_______________________
Rental Agreement To keep rental and purchase prices as reasonable as possible, it is the Family Center’s 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:___________________

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:	_________________________________________________________________________

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