Order Form 

Educational Materials

Simply fill out the following form, print it off your screen and send it to us along with cashier's cheque or money order :
Amberheart Breast Cancer Foundation
Suite 206 - 2571 Shaughnessy Street
Port Coquitlam, BC. V3C 3G3
Canada

 

or pay directly to our bank acc.

Bank of Montreal : Amberheart – Breast Cancer Foundation Community Account # 27070-001 8036-935

and fax this form to us along with a proof of payment: (604) 942 3087

 

upon receiving the payment please allow 14 -28 days  for delivery.

% --------------------------------------------------------------------------------------
  Order Form
First Name:
Last Name
Address:
City:
Province/ State:
Postal Code/ Zip:
Telephone:
Email:

 

BSE DVD     

$ 25         more than 10

each $ 20 

All prices in Canadian Dollars
MAPPS CD  $ 15         more than 10 each $ 10    
Mapps - booklet 

$   2.50    more than 100

 each $   1.50
Educational kit (with DVD) 

$ 28          or (with CD)

 each $ 18
Wooden beads   $   5         each  

               

             I'd like to order                Qnt                                                $ CAD                           $ CAD
BSE DVD     less than 10      10 or more
MAPPS CD    less than 10        10 or more
MAPPS -Booklet    less than 100    100 or more
Wooden Beads  
Educational Kit  
GST 6%
Amount:
Shipping & handling  
Xpresspost up to 1 kg Canada:  Regional $10;  National $15  (1-2 business days)       USA : $23 (3-5 business days)
Regular Parcel up to 1 kg Canada:  Regional $8;  National $12  (3-9 business days)         USA : $15 (4-10 business days)
Small Package Air up to 1kg $30 International  (6 to 10 business days to most international destinations.)
Total Amount: $ CAD