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Stress Management > Video Order Form
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 VIDEO ORDER FORM
Eastern Mountains Relaxation Video
CALL:
1-985-649-2011
(orders only)
GET FREE RELAXATION AND STRESS REDUCTION GUIDE WITH VIDEO
FOR A DESCRIPTION OF THE VIDEO USE THE LINK
AT LEFT SIDE OF PAGE:
''Eastern Mountains Relaxation Video''
Produced by
David W. Kidder, Ph.D.
Psychological Technologies, L.L.C.
ORDERING INSTRUCTIONS: Please send check written to David W. Kidder, Ph.D.. Include your name, street address, apartment or suite number, city, state, and zip code with your order. It will also help us to help you if you provide your email address in case of questions. We do not accept credit cards. For mail orders you may use the form at the end of this page by printing this page and cutting off the form.
WRITE TO:
David W. Kidder, Ph.D.
893 Brownswitch Rd., Suite 207
Slidell, LA 70458
FOR BUSINESS OTHER THAN ORDERING:
985-649-2011
(To leave message for Dr. Kidder or staff)
Order form must be accompanied by check.
PRICE LIST:
_____________________________________________
Louisiana Customers:
CONSUMER, PERSONAL USE ONLY:
Tape $19.95
Tax $1.50
S&H $4.95
________________________
Total $26.40
PUBLIC PERFORMANCE RIGHTS:
Tape $99.00
Tax (8.75%) $8.66
S&H $4.95
________________________
Total $112.61
_____________________________________________
Out of State Prices:
CONSUMER, PERSONAL USE ONLY:
Tape $19.95
Tax 0.00 (Customer responsible)
S&H $4.95
_________________________
Total $24.90
PUBLIC PERFORMANCE RIGHTS:
Tape $99.00
Tax 0.00 (Customer responsible)
S&H $4.95
__________________________
Total $103.95
_____________________________________________
FOR QUANTITY DISCOUNTS, CALL FOR PRICE QUOTE:
1-985-649-2011
NOTE:
Public performance rights are special permission to show the video for a public audience, lend it out, rent it, or in any way use the tape for multiple showings to more than one consumer. When you purchase the video at the $99.00, you are granted these rights. No special forms are required. The record of sale is yours and our documentation of the purchase of these rights.
Mail this form to David W. Kidder, Ph.D.
893 Brownswitch Rd., Suite 207, Slidell, LA 70458
___________________________________________________________
Name:___________________________________
Street:__________________________________
Suite or apt:_________
City:____________________________________
State:_______ Zip code:_______________
Email:___________________________________
Telephone number:________________________
Number of videos ordered:________
Total price to remit:____________ |
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