Printable Order Form

Caregiver's Checklist: A Personal Experience
Printable Order Form

Mail To:

In Memory Of, inc.
1446 Huffman Ave.
Dayton OH 45403-3019

Method of Payment:

Check or Money Order

with your order.

Shipping Information:

Name: __________________________________________________________

Address: __________________________________________________________

__________________________________________________________

City, State, Zip: _____________________________________________________

Phone Number: _____________________________________________________

   I would like: ____copies @ $19.95 each:
                                +S&H @ $3.30 each:
                          Subtotal:

Sales Tax @ 7% (Ohio residents only)

Total:

   $___________
   $___________
   $___________

$___________

_____I would like information about a volume discount for 5 or more books.
(For volume discount information, please print this form and mail to us.)

Or just click this link to Amazon.com and purchase Caregiver's Checklist":