Henci Goer

Informed Choices in Childbirth

Instructions

You may use this order form in two ways:

  1. Print it out, fill it out, and mail it with credit card information or your check or money order payable to Henci Goer, to:

    Henci Goer
    970 Buckeye Drive
    Sunnyvale, CA 94086

    OR

  2. Copy the order form into an email message, fill it out, and send it, along with your credit card information, to Henci at goersitemail@aol.com.


Order Form

Emailing Credit Card Numbers
To email your credit card number, we suggest sending two emails. The first email should contain half of the credit card number and expiration date:

1234 5678 XXXX XXXX
exp date: 07/XX

The second email should contain the other half of the credit card number and expiration date.

XXXX XXXX 3141 5926
exp date: XX/05

The Thinking Woman's Guide to a Better Birth

___ copies x $17.00 each =_______

Discounts: 1-2 books: subtract 10% _______
3-10 books: subtract 20% _______
over 10 books: subtract 30% _______
Subtotal after discount _______

Plus Postage and handling _____

One book, U.S.: $4.95

For orders of multiple books or international shipping
rates for specific countries, contact Henci Goer.

Plus tax ______
If you live in California, add 7.25% sales tax
If you live in Santa Clara County, CA, add 8.25% sales tax

Total _______

Payment by
__Check __Money Order (U.S. dollars only)
__ Visa __MasterCard

Card Number___________________________________________________

Expiration Date:________________

Name as it appears on the Card:

___________________________________________________

Billing address (required)

Name: ______________________________________________________

Street Address: _______________________________________________

City/State or Province/Zip/Country:
_____________________________________________________________

Telephone: ___________________________________________________

E-mail Address: _______________________________________________

Shipping address (if different from billing)

Name: ______________________________________________________

Street Address: _______________________________________________

City/State or Province/Zip/Country:
_____________________________________________________________

If you would like your book inscribed, to whom shall I address the inscription?

_____________________________________________________

Copyright 2002-2006, Henci Goer: All Rights Reserved. This site respects your privacy.
Last Updated Saturday, 19-Nov-2011.