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Raymond Lloyd Richmond, Ph.D.
1592 Union St #83
San Francisco, CA 94123
(USA) |
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Mail Order Form
Instructions |
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1. |
Print this form on your printer;
then fill it out, PRINTING legibly. |
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2. |
Mail the completed form to the address
above. |
_____________________________________________________________________________________________________________
NAME
 (please
PRINT legibly) |
_____________________________________________________________________________________________________________
NUMBER &
STREETAPARTMENT,
SUITE, etc. if applicable |
_____________________________________________________________________________________________________________
CITY, STATE, & POSTAL CODE |
___________________________________________
COUNTRY (If not USA) |
____________________________________________________
PHONE (Necessary for international delivery) |
______________________________________________________
E-MAIL (Optional, if you would like notification when your order has
shipped) |
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Price |
Quantity |
Amount |
Guided Imagery Relaxation CD
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
$ 9.95 |
_________ |
__________ |
Borderline Personality Disorder booklet
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
$ 8.30 |
_________ |
__________ |
Breviary and Lectionary Pronunciation
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
$ 8.30 |
_________ |
__________ |
Catholic Compassion booklet
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
$ 8.30 |
_________ |
__________ |
Desire and Distraction booklet .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
$ 8.30 |
_________ |
__________ |
Giving the Pain to God booklet
. . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . |
$ 8.30 |
_________ |
__________ |
Stopping Smoking booklet
. . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . |
$ 8.30 |
_________ |
__________ |
Prayer Cards (specify):
___________________________________________
Use additional paper if necessary
If prayer cards are ordered with booklets, do not include the prayer cards in the
shipping calculation. |
$ ____ |
_________ |
__________ |
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SHIPPING & HANDLING: Domestic
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Order Totals |
|
Add |
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up to $9 |
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$4.50 (First Class mail) |
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over $9 |
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$9.50 (Priority Mail) |
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SHIPPING & HANDLING: International
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Order Totals |
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Add |
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Under $9 |
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$5.00 (First Class Mail) |
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Over $9 |
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$55.00 (International Priority
Mail)
$95.00 (International Express Mail) |
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Shipping and Handling |
__________ |
Subtotal |
__________ |
CA addresses add sales tax
8.5% of Subtotal (items plus shipping) |
__________ |
TOTAL |
__________ |
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• Enclose a check (USA
only) or money order (USD) payable to R. Richmond, Ph.D. |
• For payment with a
credit card (Mastercard, Visa, or Discover), fill in the following
information: |
Account
number:
___________ - ___________ - ___________ - ___________ |
Expiration Date
(MM/YY): __ __ / __ __
Verification number: __ __ __ |
Signature:
_______________________________________________________ |
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