DVD Order Form

New DVD Available!



Moving through Conflict:  An Introduction to Mediation
with Teresa V. Carey



Just $25 each
(add your local California sales tax if ordering from or shipping to a California address)
plus shipping and handling
($10 per order for 1-3 DVDs, $15 per order for 4-9 DVDs;
for discounted rate, call if ordering 10 or more)

To order the DVD, simply print out this form
and send it with payment to the address below.

Name  
Company/Organization  
Address  
   

Additional Contact Information (any you think will be useful if we need to contact you)
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Payment Options

____
I am paying by CHECK (made payable to "Professional Mediation Associates") mailed to Professional Mediation Associates, 700 Larkspur Landing Circle, Suite 199, Larkspur, CA  94939).

____
I am paying by CREDIT CARD.  My
____ Visa
____ MasterCard
number is ________________________________, and the expiration date is __________.

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If the name and address shown above do not match what is shown on my credit card billings, the name/address associated with my credit card is/are:
_____________________________________________________________________________

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My authorization signature:  x__________________________________________________

  

 Send completed form, with payment, to:

Professional Mediation Associates
      

700 Larkspur Landing Circle, Suite 199

Larkspur, CA 94939

t.carey@ix.netcom.com



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