PASSAGES ® - Canadian Independent Group of Funeral Homes

NON-MEMBER
ORDER FORM
PA S S A G E S
®
SERIES OF PUBLICATIONS FOR TIMES OF GRIEF AND LOSS
Ordering Information
Please fill in the following information:
Please note: all orders are in multiples of 10.
Quantity
Title of Brochure
Name:
Coping with the Death of a Child [BR-1 ENGLISH]
Composer avec la mort d’un enfant [BR-1 FRENCH]
Firm Name:
Coping with the Death of a Friend [BR-2 ENGLISH]
Composer avec la mort d’un ami [BR-2 FRENCH]
Address:
Coping with the Death of a Parent [BR-3 ENGLISH]
Composer avec la mort d’un parent [BR-3 FRENCH]
Coping with the Death of a Sibling [BR-4 ENGLISH]
Composer avec la mort d’un frère ou
d’une soeur [BR-4 FRENCH]
Fax:
E-mail:
Coping with the Death of a Teenager [BR-6 ENGLISH]
Composer avec la mort d’un adolescent [BR-6 FRENCH]
Total Brochures/Booklets Ordered
Trauma in the Community [BR-8 ENGLISH]
Une communauté traumatisée [BR-8 FRENCH]
Will and Estate Planning [BR-9 ENGLISH]
Votre testament et la planification
de votre succession [BR-9 FRENCH]
Coping with Grief During the Holidays [BR-10 ENGLISH]
Composer avec le deuil pendant la saison
des Fêtes [BR-10 FRENCH]
Unit Pricing Chart for Brochures
The cost per brochure is based on the total number of brochures ordered.
10-100
$1.39
110-500
$1.29
510-1,000
$1.19
Title of Booklet
Your Grief: The First Painful Days [BK-2 ENGLISH]
Votre chagrin : Les premières journées de deuil [BK-2 FRENCH]
Unit Pricing Chart for The Funeral
(English or French)
The cost per brochure is based on the total number of booklets ordered.
10-100
$1.59
110-500
$1.49
510-1,000
$1.39
1,010-5,000
$1.29
Unit Pricing Chart for Your Grief
(English or French)
The cost per brochure is based on the total number of booklets ordered.
10-100
$1.99
110-500
$1.89
510-1,000
$1.79
Sample Pack.
(Please refer to Pricing Charts)
_____ × ______¢ = $
(1)
_____ × ______¢ = $
_____ × ______¢ = $
(2)
Sample Packs [SAMP-1]
_____ × ______¢ = $
(4)
Starter Kit [START-1]
_____ × $189.95 = $
(5)
Overprint Pricing
_____ ×
= $
(6)
$20.00 = $
(7)
Brochures [BR-1 to BR-10]
Booklets
The Funeral
Your Grief
[BK-1]
[BK-2]
Administration Fee
Orders under 500 units are
subject to a $20 administration fee.
1,010-5,000
$1.09
The Funeral: Its Meaning and Purpose [BK-1 ENGLISH]
Les funérailles : Leur signification et leur but [BK-1 FRENCH]
Quantity
Telephone:
Coping with the Death of a Spouse [BR-5 ENGLISH]
Composer avec la mort d’un conjoint [BR-5 FRENCH]
Death from a Male Perspective [BR-7 ENGLISH]
La mort telle que perçue par un homme [BR-7 FRENCH]
Quantity
Postal Code:
1,010-5,000
$1.69
One copy of each brochure and booklet.
Please add applicable tax:
Card number
Starter Kit
English Starter Kit [START-1 ENGLISH]
French Starter Kit [START-1 FRENCH]
$
( 13% of line 9)
$
Order Total
$
(9)
Payment must accompany order.
VISA
Expiry date
Signature
TO ORDER,
FAX OR MAIL THIS FORM TO:
1,010-5,000
$12.09
Ten copies of each brochure and booklet.
Unit Pricing for Starter Kits
The cost per Starter Kit is $189.95 plus HST.
Price includes shipping and handling.
$
(8)
Cardholder name
CANADIAN – INDEPENDENT
GROUP OF FUNERAL HOMES
Overprinting on the back cover is not available for Sample Packs.
Quantity
Shipping
Cheque/Money Order enclosed – Make payable to:
Canadian-Independent Group of Funeral Homes
Charge my
American Express
MasterCard
The cost per pack is based on the total number of packs ordered.
510-1,000
$13.29
$
Net Total
HST
Method of Payment
Unit Pricing Chart for Sample Packs
110-500
$15.99
Subtotal
(8.5% of order, minimum $6.50)
English Sample Pack [SAMP-1 ENGLISH]
French Sample Pack [SAMP-1 FRENCH]
10-100
$17.89
10¢
(3)
Visit our
website at:
www.cigfh.ca
1485 Laperriere Avenue
Ottawa, ON Canada K1Z 7S8
Telephone: (613) 729-7072
Fax: (613) 729-6206
R–11/2010

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