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.


Additional Contact Information (any you think will be useful if we need to contact you)
Work Tel   Home Tel  
Cell Phone   Email  

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 __________.

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:

My authorization signature:  x__________________________________________________


 Send completed form, with payment, to:

Professional Mediation Associates

700 Larkspur Landing Circle, Suite 199

Larkspur, CA 94939


Home | Offerings | Instructors & Speakers | Participant Comments | Mediation Services | FAQs | Contact Us | Registration