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Order form for the CPM Brochure

Use this form to order brochures in bulk. For a free sample copy, send a business-sized self-addressed stamped envelope to the address listed below.

Send to (PLEASE PRINT)

Name ___________________________________________________

Street Address ____________________________________________

City _________________________ State & Zip __________________

Home Phone _________________ Office Phone _________________

e-mail address (required) ______________________________________

Are you a CPM? _____ Yes _____ No

____ 25 CPM Brochures $15.00 including postage  $_________

____ 50 CPM Brochures $25.00 including postage  $_________

____ 100 CPM Brochures $37.00 including postage $_________

____ Total Items Ordered for this total amount $_________

All fees must be paid by credit card. NARM no longer accepts cashiers checks, money orders, or personal checks. After we receive this form, you will receive an invoice by email with a direct link for credit card payment.

You may either print and mail this form to:
The North American Registry of Midwives
PO Box 420
Summertown, TN 38483

Or you may email the information above to:
applications@narm.org