Order Form

Name_______________________________________________________

Address____________________________________________________

City________________________________State______Zip_________

Phone______________________________________________________

Email______________________________________________________

Please send me the following items:
Qty Description                                            Amount
__ Audio CD - Your Body, Your Birth $14.95.................$______ 
__ Book - Unassisted Homebirth: An Act of Love $19.95......$______ 
__ Childbirth Success Kit $59.95...........................$______ 

___ Conference Tape #1
    Welcome/KeyNote $6.00...................................$______
___ Conference Tape #2
    Covenant of Love/Reluctant Fathers $6.00................$______
___ Conference Tape #3
    Preparing for an Unassisted Homebirth $6.00.............$______
___ Conference Tape #4
    Birth Stories $6.00.....................................$______
___ All Four Conference Tapes $20.00........................$______
___ Doctor-delivered Babies and Natural Law: A Conflict
    Between the Two" by Marilyn Moran $3.00 ................$______
                                         
                                                 Sub-Total  $______
Shipping/Handling based on sub-total:                       $______
US
$4.00  for $0.01   - $29.99
$7.00  for $30.00  - $59.99
$9.00  for $60.00  - $99.99
$11.00 for $100.00 - $129.99
$13.00 for $130 and up
International
$12.00 for $0.01 - $29.99 
$15.00 for $30.00 - $59.99 
$17.00 for $60.00 - $99.99 
$19.00 for $100.00 - $129.99 
$22.00 for $130 and up

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Send completed form with        |                      Total$______
check or money order payable to:|  
                                |
Terra Publishing                |
4103 Plaza Lane                 |
Fairfax, VA 22033               |
                                |
Allow 2 Weeks for Delivery      |
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