SSQ I and SSQ II Tape Order Form

Name________________________________________________________________

Address______________________________________________________________

City____________________________________State_________Zip______________

Country _________________________

Home Phone (_____) _______________    Work Phone (_____) ______________

Email ________________________________________________________________

Title	Unit Price	Quantity	Cost
A. SSQ I Berkeley Conference Video Featuring over 20 distinguished scientists on broad themes of science and spirituality. 2-tape set, 112 minutes, VHS format, June 1998.	US$ 39.00
B. SSQ II Silicon Valley Conference Video Featuring 6 technology leaders on "Creativity, Spirituality, and Computing Technologies." 2-tape set, 114 minutes, VHS format, June 2000.	US$ 39.00
C. SSQ II Boston Conference Video Featuring 17 leading scientists speaking on "The Quest for Knowledge, Truth and Values in Science and Religion." October 2001 2-tape set. VHS Format	US$ 49.00
1. Subtotal Add lines A and B.			=
2. Shipping And Handling Add US$4.00 per unit for shipping within the USA For shipping outside the USA, the actual cost of shipping will be added to your credit card order.	US$ 4.00	X	=
3. TOTAL Add lines 1 and 2.

Payment Options

Credit Card (accepted for orders and shipping worldwide)
___ Visa ___ Mastercard
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Expiration: __ __ / __ __
Signature:_______________________________________________________

Check (accepted for orders and shipping only in the USA)
Important! Make check payable to "Paul Swensen Production, Inc." and enclose with your order form.

Send completed order form with payment to:

Center for Theology and the Natural Sciences
2400 Ridge Road
Berkeley, CA 94709-1212

TEL: 510-848-8152
FAX: 510-848-2535
EMAIL: ctnsinfo@ctns.org
WEB: www.ctns.org/ssq