|
|
|
 |
Please print this form, fill it out completely and FAX it to (408) 248-2622
|
| Item | Description | Quan | Unit | Total |
| #001 | The Balanced Life Experience, “A Road Map for Having it All” Soft Cover |
$15.95/ea. | ||
| Sub-Total | ||||
| TAX (CA residents add 8.25%) | ||||
| Shipping & Handling ($4.95 per book) | ||||
| TOTAL | ||||
|
| Last Name | First Name | Middle Initial |
|
|
|
|
| Address | ||
|
|
||
| City | State/Country | Postal Code |
|
|
|
|
| Company
Name |
Business
Phone |
Business Fax |
|
|
|
|
| Home Phone | email address | |
|
|
|
|
Method
of Payment:  Check
MasterCard Visa
|
|
| Card
#: |
Expiration date: |
|
|
|
|
Is the Credit Card billing address different from the one above?
Yes
No
|
|
| If Yes, please list address here: | |
|
|
The undersigned purchaser certifies that he has read and understands all of the terms and conditions on this invoice. All the terms and conditions are available upon request and are part of this sales order, which shall constitute a contract between parties and there are no expressed or implied warranties, modifications, or performance guarantees other than expressly stated herein. |
|
|
||
| Customer's Signature | Date | |
|
© 2001 Socratic Coach Publishing. All Rights Reserved. 1042 W. Hedding, Suite 288, San Jose, CA 95126 — 408-345-2788 • 888-593-2622 • 408-248-2622 Fax orders@socraticcoachpublishing.com |
Close This Window