PLEASE PRINT
| description | cost | quantity | amount enclosed |
|---|---|---|---|
| trigger card box set: 44 laminated trigger cards for birth planning 3 blank cards 30 potential triggers cards Containment box |
$20.00 | ||
| 11 x 17 inches full colour "A Safe Passage" poster with tear
pads - single poster |
$10.00 | ||
| 11 x 17 inches full colour "A Safe Passage" poster with tear
pads - set of three posters |
$25.00 | ||
| full colour tear pad - one pad |
$5.00 | ||
| full colour tear pads - package of 10 pads |
$30.00 | ||
| Totals |
Name: ___________________________
Address:__________________________
City:_____________________________
Postal code:_______________________
Phone:___________________________
Email:____________________________
PLEASE MAIL COMPLETED FORM to:
A Safe Passage
20 Weston St
London ON N6C 1R1
Canada
A charge of $20 will apply to all NSF returned cheques.