HepCBC Printable Order Form

1. Print this page.

2. Fill out to subscribe, volunteer, donate, or join.

3. If payment is required, please include a cheque for the total, and send to the following address:

HepCBC
P.O BOX 46009
2642 Quadra St
Victoria BC, V8T 5G7
Tel:(250) 595-3892

Name:

Address:

Please include Postal Code in your address.

Phone: (home): (work):

Email:

Membership & Subscription (1 year)......$20.

Membership Only................................$10.

Subscription Only................................$10.

Peppermint Patti's FAQ V8..........................$12.

Resource CD.......................................$10.

Total:

Please email me the pdf version of the bulletin each month.

I enclose a donation of $________ so that others may receive the bulletin.

I want to volunteer. Please contact me.

I want to join a support group. Please call.