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	I would like to order the following book(s) from Hospice & Palliative Care of Westchester (more books will be posted in the future)

Living with Grief - Children, Adolescents, and Loss         $16.95/copy  Hospice Foundation of America, Kenneth J. Doka - editor, 4/2000  Add $1.00 for mailing

Copies

I am enclosing my check for the full amount of:

$

Please mail to me at the following address

Name
Number and Street
City	State    Zip
Telephone (optional)	Area Code   Number
E-Mail (optional)

How to submit your order

	After filling out the entire form above, print two copies. Keep one for your records, and mail the other - along with your check made out to "Hospice & Palliative Care of Westchester" - to: The Bookshelf at Hospice & Palliative Care of Westchester The Esplanade Fourth Floor 95 South Broadway White Plains, NY 10601
	95 South Broadway, White Plains, NY 10601 Telephone: (914) 682-1484    FAX:  (914) 682-9425     E-Mail: info@hospiceofwestchester.com © 2000 Hospice & Palliative Care of Westchester Magtree Designs - All rights reserved