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Order Form
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   A WELL-LIVED LIFE —  400 pp., $32.50 plus postage

         by Sylvia Fleming Crocker, Ph.D.


To order or for more information write:

GIC Press--1588 Hazel Dr.
Cleveland, OH 44106
Phone: 216-421-0468
Fax: 216-421-1729
e-mail: gestaltclv@aol.com

The Analytic Press
10 Industrial Ave.
Mahwah, N.J. 07430

Or:
Phone: 1-800-926-6579
Fax: 1-201-760-3735
E-mail: tapbooks@analyticpress.com
Website: www.analyticpress.com

Shipping & Handling Charges:
   USA $5.50 1st book, $1.50 each add’l
   Mexico/Canada $7.50 1st $2.00 ea add’l
   Overseas Air: $14.50 1st, $9.50 add’l



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Street, City, State, Postal Code,

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All orders must be PREPAID. Foreign checks must be in U.S. funds and drawn
on a U.S. bank. Credit cards are welcome (MasterCard/Discover/Visa ONLY—no American Express)
Complete information below.

Credit Card
#_____________________Exp.Date_______Signature_________________________

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