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 _________________

Fax ________________________ e-mail address ________________

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 / Amount Enclosed Checks payable to NARM $_________

Please mail this form, with check or money order to:
The North American Registry of Midwives
PO Box 420
Summertown, TN 38483

Phone: 1-888-842-4784 
Email: applications@narm.org

For credit card orders please contact billing@narm.org for an online invoice.