It's easy! If you have access to a printer just print this form out and just mail or fax it in.
If you don't have access to a printer just call the toll free number above or
just copy the info below and mail or fax it in.
| Families Coping With Mental Illness | ||
| Quantity |
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Price |
| __ 22-min. version |
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$_________ |
| __ 43-min. version |
|
$_________ |
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(prepaid by check, MC, or VISA) |
||
| __ 22-min. version |
|
$_________ |
| __ 43-min. version |
|
$_________ |
| Shipping & handling: $9 per shipment* | $_________ | |
| Tax-deductible contribution to the Mental Illness Education Project: |
$_________ | |
| TOTAL: | $_________ | |
YES! Send tapes to the address I have given below.
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____My check (or institutional purchase order) for |
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| ____Charge my: | ___MC | ___VISA |
| ___________________________________ ____/____/____ | ||
| Account number | Expiration date | |
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| Signature | ||
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| Name | ||
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| Address | ||
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Send or fax order form to:
Mental Illness Education Project Videos
22-D Hollywood Ave., Hohokus, NJ. 07423
Credit card orders: 1-800-343-5540
Fax: 1-201-652-1973