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Puzzle of Perimenopause Order Form

To order The Puzzle of Perimenopause, please print and fill out the order form below.

Mail your order form to:

BC Endocrine Research Foundation
281-828 West 10th Avenue
Vancouver BC V5Z 1L8

Yes! I wish to make a donation and receive The Puzzle of Perimenopause video.

 

Name
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Address

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City/Town _____________________________________
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Please send me __________ Videos.

I enclose a donation (cheque, money order, or credit card) in the amount of $35 Cdn ($25 US) for (PAL Version = 25 Euro) EACH video, payable to the:

BC Endocrine Research Foundation
281-828 West 10th Avenue
Vancouver BC V5Z 1L8

Payment Method:
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Yes. Please send me a tax receipt for my donation (Minus costs for video production, shipping and handling).

We Rely On Your Support

If you find these materials helpful, and if you are able, please consider making a donation to cover our costs and support the research and education objectives of the Centre for Menstrual Cycle and Ovulation Research.

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