ORDER FORM

Quantity        Item                                                                    Unit Price         Total

_______       Dealing with Death Book                                         $16.95           _______ 

_______       Dealing with Death Companion CD                         $18.95           _______   

_______       Stress Relief and Sleep CD                                     $12.95           _______   

_______       Letting Go CD                                                         $12.95            _______ 

                     Product Total                                                                                 _______ 

Shipping and Handling:

(Within Canada: $5)

(Shipping to USA:  $7)

                                                                                       _______

                      Sub Total                                                                                       _______

                      Add 5% GST for all deliveries within Canada                                ________

                       TOTAL ORDER                                                                            ========

My check or money order payable to Pegasus Healing and Empowerment                                          For $___________ CDN is enclosed.

Please mail to

Pegasus Healing & Empowerment

126 Hawkview Manor Court NW, Calgary AB, Canada T3G-2Y9

I prefer to pay the total amount of $__________ CDN by Visa or MasterCard (please circle which)

Credit Card # (please print clearly)  __________________________________

Expiration Date  ___________ 

Signature _______________________________

Fax form to 1-403-686-3177

or Mail to Pegasus Healing & Empowerment

126 Hawkview Manor Court NW, Calgary AB, Canada T3G-2Y9

Name: _____________________________________________________________________

Address (incl. postal code or zip code): _______________________________________________

 _______________________________________________

________________________________________________

Phone: (_____)__________________  Email Address: _______________________________

Shipping address if different than above:            ________________________________________________

________________________________________________

________________________________________________

A formal receipt will be issued at the time of shipping and you will be notified when your order is on its way.     Thank you for your order.