Poster Order Form

For the Teri Posyniak Poster “Sanctuaries”

Quantity / X $20.00 = / $
Shipping & Handling / $8.00
Total Cost / $

(Note: GST is included in price)

Payment Method

Make cheque or money order payable to Prairieaction Foundation. Please note your cheque must be received at the Prairieaction Foundation office prior to shipment of poster.

Shipping Instructions

Name: ______
Institution/Organization: ______
Street Address: ______
City: ______Province: ______Postal Code: ______
Country: ______Telephone: ______
Fax No: ______E-mail: ______

* Please allow 10 working days for delivery within Canada.

Send this form to:

Email:

Mail: 31250 Woodland Way, Calgary, Alberta, T3R 1G5

If you have any problems completing this form, please email or call us at: 877 926 8129

Thank you for supporting solutions to violence and abuse.

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