winter 20113     spring 2013     fall 2013     a future edition(s) (please specify):

If you have reserved for more than one edition, please indicate whether you would prefer to pay for them:all at once   as each edition is published

Please reserve for us the following space:

full page @ $260 per edition

1/2 page @ $155 per edition

1/4 page @ $90 per edition

1/6 page @ $61 per edition

business card size @ $36 per edition

other (please specify size): price quoted by CPF Alberta: $

Subtotal: $  (rate x number of editions)

Discount for CPF member organizations: membership number:  expiry date:

subtract 15% of subtotal <$>

Discount for three consecutive editions:                discounts cannot be combined

subtract 10% of subtotal <>

Total payable: $

Method of payment:

please send us an invoice for our purchase order #

a cheque made to "CPF Alberta" is being mailed to Box 34094 RPO Kingsway, Edmonton AB  T5G 3G4

by credit card:  MasterCard   VISA

 name as shown on card:

card number:  expiry date:

This information is submitted by:

Name:

Title:

Company/institution:

Mailing address:

City:  Province:  Postal code:

Phone:     E-mail: 

Comments/questions: