____ Coming Fully Alive As You Age DVD & User Guide—$97 per set
____ Subtotal
____ California residents add $8 sales tax per set
____ Shipping & Handling $5 per set
____ Total*
Please fill out your ship-to information. Allow two weeks (from the time
we receive your payment) for delivery:
Name: ______________________________________
Address: ______________________________________
City: ___________________________ State: _____
Zip Code: ______________________________________
E-mail: ______________________________________
Phone: ______________________________________
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*Note: Please make your check or money order payable to Concept: Creative
and send with this form to:
Senior New Ways
655 Magdalena Avenue
Los Altos, CA 94024
Phone: 650 209 1119
Email: info@seniornewways.org
www.seniornewways.org
| Coming Fully Alive As You Age Order Form |