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					                                                      ORDER FORM                                   Your Journey Books
                                                                                                   Helping People During Life's Final Journey
Send this order to the address below

  Your Journey Books
  604 Bucknell Ave.                                                                                     DATE
  Big Spring, Texas 79720
  Ph 432-517-4508 Or: 877-275-9624                                            CUSTOMER PURCHASE ORDER #
  Fax: 432-517-4509


  ORDERED BY:                                       Ship To
Company Name                                        Name
Street Address                                      Company Name                                                     Phone
City, State Zip                                     Street Address                                                     Fax
Phone                                               City                                                             e-mail
Fax                                                 State, Zip

                                                                                                                                  PAYMENT
                                                        SHIPPING                      SHIPPING                    SHIPPING
                               Packed By                                                                                       TERMS (with prior      DUE DATE
                                                        METHOD                         TERMS                        DATE
                                                                                                                                  approval)

                                                                                                                                     Net 30


        QTY                    Language                                       Title                              UNIT PRICE       QTY shipped         LINE TOTAL
                                 English                           Your Journey Through Grief                    $     1.25
                                Spanish                            Your Journey Through Grief                    $     1.25
                                 English                         Your Journey Through Life's End                 $     1.25
                                Spanish                          Your Journey Through Life's End                 $     1.25
                                 English                      Your Journey Through Life's Treasures              $     1.25
                                Spanish                       Your Journey Through Life's Treasures              $     1.25
                                 English                         Your Journey Through Caregiving                 $     1.25
                                 English               Your Journey To A New Normal: Member's Booklet            $     1.25
                                 English               Your Journey To A New Normal: Facilitator's Guide         $     1.25



                      Add total # of booklets of ordered and place that total in the box to the left. Use that
                                                 total to determine shipping costs.
 Shipping is based                                                                                                On each booklet: multiply the
on total number of      Select the proper shipping fee based on the total number of booklets ordered and         Qty ordered by the unit price
 booklets ordered                   place the proper shipping fee in the box next to Shipping                    and place that amount in the
                                                                                                                 LINE TOTAL column. Add that
   1-4 booklets                  $3.00                                                                           column and enter the amount in
  5-25 booklets                  $5.00                                                                           the Total booklet Price Box.

 26-250 booklets                 $11.00                                                                                       Total Booklet Price
251-499 Booklets                 $20.00                                  NOTE: Only orders placed from or                               Shipping
                                                                       shipped to a Texas address: multiple
over 500 Booklets          FREE (Best Value)                            the subtotal by 8.25% and enter that                           SUBTOTAL
                                                                             amount in the sales tax box     Sales Tax                        8.25%
                                                                                                                              TOTAL AMOUNT DUE

NOTE: You must have prior approval to order
with a 30 day charge account. Call 432-517-4508
                                                              If paying by check please make it payable to: Your Journey                        Books
or 877-275-9624 to apply for an account.                                       THANK YOU FOR YOUR BUSINESS!