Caring for Drug Exposed Infants 

by Barbara Drennan

Order Form

Ship to / NAME:________________________________________________________________
ADDRESS:_______________________________________________________________________
STATE _________________________________ ZIP__________________________
PHONE:____________________________________
EMAIL:___________________________________________________________

DVD - $75.00  donation each (orders of 2 or more, $50.00 each)
Quantity___________ (shipping included - US only)
$________________________

BOOK - $10.00 donation each
Quantity___________ (shipping included - US only)
$________________________

BOOKLET - $5.00 donation each
Quantity___________ (shipping included - US only)
$_______________________

TOTAL ORDER $_________________________

(for international orders please call PICC at 253-852-5253 for rates)
PRINT THIS FORM and MAIL TO:
Pediatric Interim Care Center
328 4th Avenue South
Kent, WA 98032