To order this book, download this form and fax or mail it as indicated below.

        By ordering in this way you enable GriefNet 
         to receive a portion of the purchase price 
                to help us in our work. 


                      ORDER FORM - GALEN PRESS
                      ------------------------


Your Name_______________________________________________


Address ________________________________________________


City _________________________  State ____  Zip ________



Product Title                            Qty.       Price       TOTAL
-------------                            ----       -----       -----       

Death to Dust                            _____      $38.95      _____
  (see below for multiple copies price)

After Death Planning Guide               _____       $3.00      _____

Arizona residents add 7% sales tax                              _____

Shipping & Handling:
   $3.00 for first book & $1.00 for each additional book. 
   These are sent library of book rate in U.S.
No extra cost for shipping the After-Death Planner. 
The price includes shipping.                                    _____

To ship USPS Priority Mail:
  add $2.95/each book                                           _____

Shipping to Canada, Add $3.00/book                              _____

To ship elsewhere in the world, call or write for costs


TOTAL (U.S. Funds or Visa/Mastercard only)                      _____


Please send me the products I have selected.  

___ I am enclosing my check or money order for $_________

___ Please charge to ___ Visa   ___ Mastercard

Account # ______________________________________________________

Expiration Date: ____________

[NB: DO NOT try to order via email and credit card.  The Internet is not
yet secure; your numbers may be intercepted and stolen and merchants are
not allowed to use credit card numbers received by email.]


Send to: 

  GALEN PRESS, Ltd.                     A portion of the proceeds
    P.O. Box 64400                        of this sale will go to 
Tucson, AZ, 85728-4400                       support GriefNet.       
                                                  Thank you!

Phone: 602 / 577-8363
Fax:   602 / 529-6459
*****************************************************************************

                        ADDITIONAL INFORMATION

Multiple Copies: If you wish to purchase more than five copies at a time,
   contact us about the price.

Our policy on "desk copies" for teachers who want to review the book for 
possible inclusion in a course, is that if the request is on school stationary,
the individual can get %20 off the price. The entire price of the book is 
refunded for purchase 10 or more copies. 

Dr. Iserson is available both to the media and to lecture to meetings. 
Contact him either through Galen Press or through his numbers (above). 
His speaking engagements are now being booked more than a year in advance,
although some openings do exist for the next 12 months. 

Kenneth V. Iserson, M.D., MBA
Director, Arizona Bioethics Program
Professor of Surgery
University of Arizona Health Sc Cent
1501 N. Campbell Avenue
Tucson, AZ  85724
(602) 626-2398
(602) 529-6459 Fax
[email protected]