DVD order

First name: _____________________________ Family name: ___________________________

Address : _________________________________________________ Apt. : _______

City : ______________________________________ Zip code: _______________
Country :
Phone. : ___________________Email : ______________________________________

DVD SLEEP: How to Sleep Well. . . . . Quantity ____

DVD DREAMS: How to Decode your Dreams- . . . . . Quantity ____

Cost : 24,95 $ CDN each. Total with shipping fees :

Canada	USA	Europe
1 DVD : 30 $ CAD 2 DVD : 55 $ CAD 3 DVD : 75 $ CAD	1 DVD : 33 $ CAD 2 DVD : 58 $ CAD 3 DVD : 78 $ CAD	1 DVD : 35 $ CAD 2 DVD : 60 $ CAD 3 DVD : 80 $ CAD

From 3 DVD and over add 20$ CDN to each

Qt of DVD: ______ Total : ___________$ CAD
Check or money order to Nicole Gratton
Credit card : # ______________________________________ Exp.: _____
Holder name: ___________________________________________________

Address: 3375, blv. Gouin-Est, # 704, Montréal, Qc.Canada H1H 5M1
Information: info@nicolegratton.com (514) 326-6136