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Three convenient ways to order:

1. CALL 778-772-7776 and place your order by leaving a message.
2. Print this order form and mail to address below.
3. For large orders request a quote at sales@CruiseRespite.com

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Please send

The Living Dementia Case-Study Approach to:

Contact:___________________________________________

Company:__________________________________________

Address:___________________________________________

City:______________________________________________

Prov:_____________________Postal Code:______________

Country:Canada

Daytime Telephone:(________)________________________

Email:_____________________________________________

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Number of Copies: __________

Book Total: _______________ ($20 x number of copies)

Postage & handling: $5.00 first book + $3.00 each additional book

Subtotal: $____________(Book Total + postage & handling)

GST ___________ (6% x SubTotal)

TOTAL ENCLOSED: CD$____________________ (Subtotal + GST)

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Payment Method (include with order form)

Cheque or money order enclosed, made payable to CruiseRespite Solutions

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Mailing Address