ORDER FORM  (or download printer-friendly Acrobat form)

ITEM #

QTY

TITLE

PRICE

TOTAL
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Orders to
 countries
outside
the U.S.
will be
charged
current
rates

SHIPPING & HANDLING (U.S.)
TOTAL:
 
USA Chapter 10% DISCOUNT:  
(does not apply to wristbands, Candle Lighting Buttons or 10 CD set) 
SUBTOTAL:

Shipping & Handling (U.S.):
Add $8.00 surcharge for orders shipped
outside the U.S.
Subscription to 
"We Need Not Walk Aloneฎ" ($20):
 

TOTAL AMOUNT:
   
Up to $10.00................$4.50          
$10.01 to $25.00................$6.50          
$25.01 to $50.00................$9.50          
 $50.01 to $75.00................$12.00          
 $75.01 to $100.00................$15.00          
$100.01 to $150.00................$17.00          
 $150.01 to $300.00..............$20.00         
Over $300.00................7% of total     

PAYMENT
METHOD

 Check #  

Purchase Order #

  
VISA or MC #  __  __  __  __   –   __  __  __  __   –  __  __  __  __   –   __ __ __ __
Expiration Date

          /                 

 
Name on Card  


S
H
I
P

 Name:

Please include check or money order (U.S. funds)
with order payable to
THE COMPASSIONATE FRIENDS
Mail to: P.O. Box 3696
Oak Brook, IL 60522-3696
Company/Chapter:
Address:
Address 2:
City:                                                    ST:              Zip:
Phone #:

B
I
L
L

   Company/Chapter:


Charge or invoice orders can be faxed
to (630) 990-0246 or
placed by phone toll-free (877) 969-0010
Attn:
Address:
City:                                                ST:                  Zip: