Dr. Bruce Goldberg Secured Order Form


Name of Tape #1

Name of Tape#2

Name of Tape#3

Name of Tape#4

Name of Book#1

Name of Book#2

Name of Book#3

Name of Book#4

Payment Information

*   Required fields
Name*
Address*
City and State*
Orders cannot be processed without zip code or postal code.
Zip code or Postal code*
Country*
Day time Telephone*
Email*

Please Enter Your Credit Card Information

Orders cannot be processed without a credit card CVV number.
Type of Credit Card*
Name on Credit Card*
Credit Card Number*
Expiration Date*
CVV number*
Total Amount $

Please Include Shipping Charges See Below

Each audio tape is $13.00

Albums contain 6 tapes and are $65.00

Each single CD is $17.00

CD Albums contain 6 Titles and are $75.00
Video tapes are $35.00 each.

California residents must include 9.5% sales tax. Shipping and handling
is as follows:


U.S. Postage Rates
Orders from $12.01 to $21.00....add $4.50
Orders from $21.01 to $32.00....add $5.00
Orders from $32.01 to $42.00....add $5.50
Orders from $42.01 to $53.00....add $6.00
Orders from $53.00 to $100.00...add $6.50
Add 6% to orders over $100.00
All sales are final

For US. priority mail add $6.65 (or actual shipping charge) to the above regular charges. See www.usps.com for actual charges.
For overnight delivery add $30.00 to the regular shipping charges.

For Outside U.S.:

  1. First-Class Mail International for packages up to four pounds. This is the slowest service. Add actual charges (www.usps.com). The minimum charge is $15.00 plus the above charges.

  2. Priority Mail International. Faster delivery. Add actual charges (www.usps.com). The minimum charge is $25 plus the above charges.

  3. Express Mail International or Federal Express. Fastest delivery. Add actual charges (www.usps.com). The minimum charge is $60 plus the above charges.

(Remember) For overnight delivery add $30.00 to the regular shipping charges.

(Remember) For priority mail add $6.65 to the above regular charges.

Please add any additional information below:
Be sure to indicate CDs or cassettes, DVDs or VHS and total your order.

Include shipping charges and whether you want Priority mail or Fedex.
I UNDERSTAND THAT ALL SALES ARE FINAL.

Please Enter the Ordering Person's Name:

Name     
Email   
Tel      
FAX                                               


Other methods to order:
1. You can choose to fax your order to Dr. Goldberg at: (818)-704-9189

2. You can also email your order to Dr. Bruce Goldberg at: drbg@sbcglobal.net

Copyright © 1997-2017 Dr. Bruce Goldberg. All rights reserved.
Revised: December 12, 2017.