Publication Order Form

Please print this page, complete it and either mail or fax it in with payment.

I would like to order:

___ B.C. Insurance Directories at $50.85 each ($45 + GST/PST)

___ Glossary of Insurance Terms at $31.80 each ($30 + GST)

Taxes and shipping/handling are included in the above prices.

Total: ________________________

Please send order to this address:

Please forward payment via cheque or money order, payable to:

IBABC
1300 - 1095 West Pender Street
Vancouver, B.C. V6E 2M6

If paying by Visa or MasterCard, fax this completed order form to
(604) 683-8497.

I hereby authorize IBABC to charge my
___Visa ___Mastercard for the above order.

Name: ______________________________________

Card Number: ________________________________

Expiry Date: __________

Name on Card: _______________________________

Cardholder Signature:

____________________________________________