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JCDA - Canadian Dental Association

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CDA Members Save 25% • Order Online at store.cda-adc.ca.<br />

Brochures sold in packs of 10, one language • Available in English or French • All prices CDN$ • Allow 2 weeks for delivery<br />

Total<br />

Cost<br />

$<br />

CDA<br />

Member<br />

Price<br />

25% Discount<br />

Unit<br />

Price<br />

per pack<br />

No. of Packs<br />

Product<br />

Code<br />

Please print clearly Date:<br />

English French<br />

Titles<br />

CDA member? Yes No CDA Member Number:<br />

9.00<br />

9.00<br />

PIB010E<br />

1. Bonding and Veneers (12 pages)<br />

Required for discount<br />

Check one: Dr. Mr. Mrs. Miss Ms.<br />

2. Bridges and Dentures (12 pages)<br />

3. Care after Minor Oral Surgery (8 pages)<br />

Name:<br />

4. Caring for Your Teeth and Gums (8 pages)<br />

5. Crowns (8 pages)<br />

Address:<br />

City: Province: Postal Code:<br />

6. <strong>Dental</strong> Implants (8 pages)<br />

7. <strong>Dental</strong> Safety and Emergencies (8 pages)<br />

Phone: ( ) Fax.: ( )<br />

8. <strong>Dental</strong> X-rays (8 pages)<br />

9. Do I Need a <strong>Dental</strong> Checkup? (8 pages)<br />

E-mail address (please print):<br />

Please select one: VISA MasterCard<br />

6.75<br />

6.75<br />

6.00<br />

6.00<br />

6.00<br />

6.00<br />

6.00<br />

6.00<br />

6.00<br />

6.00<br />

6.75<br />

6.00<br />

6.00<br />

6.00<br />

6.75<br />

6.75<br />

8.25<br />

6.00<br />

6.75<br />

9.00<br />

12.75<br />

PIB020E<br />

8.00<br />

8.00<br />

PIB030E<br />

PIB040E<br />

8.00<br />

8.00<br />

PIB050E<br />

PIB060E<br />

8.00<br />

8.00<br />

PIB070E<br />

PIB080E<br />

8.00<br />

8.00<br />

PIB090E<br />

PIB100E<br />

10. Early Childhood Tooth Decay (8 pages)<br />

11. Good Food, Healthy Teeth (12 pages)<br />

Card No<br />

9.00<br />

8.00<br />

PIB110E<br />

PIB120E<br />

Expiry Date<br />

12. Gum Disease (8 pages)<br />

13. Hidden Threats to Your Oral Health (8 pages)<br />

8.00<br />

8.00<br />

PIB130E<br />

M M / Y Y<br />

PIB140E<br />

Cardholder’s Name (please print)<br />

14. Oral Health, Good For LifeTM (8 pages)<br />

15. Orthodontics at Any Age (12 pages)<br />

9.00<br />

9.00<br />

PIB150E<br />

Signature:<br />

PIB160E<br />

16. Root Canal Treatment (12 pages)<br />

17. Seniors and Oral Health (20 pages)<br />

Office Contact Name:<br />

11.00<br />

8.00<br />

9.00<br />

PIB170E<br />

PIB180E<br />

PIB190E<br />

18. TMD (8 pages)<br />

19. Tooth Decay, Cavities and Fillings (12 pages)<br />

Daytime telephone: ( )<br />

12.00<br />

17.00<br />

PIB200E<br />

20. Your Child’s Oral Health (0 – 12 years) (24 pages)<br />

21. Sample Pack (one of each title)<br />

Postage and Handling Chart<br />

1-2 PACKS P&H- $5<br />

26-30 PACKS P&H-<br />

3-5 PACKS P&H- $12<br />

31-35 PACKS P&H-<br />

6-10 PACKS P&H- $14<br />

36-40 PACKS P&H-<br />

11-15 PACKS P&H- $16<br />

41-45 PACKS P&H-<br />

16-20 PACKS P&H- $18<br />

46-50 PACKS P&H-<br />

21-25 PACKS P&H- $20<br />

SAMPLE PACKS P&H $5 EACH<br />

PIB210E<br />

A. Total Brochure Cost<br />

$22<br />

$24<br />

$26<br />

$28<br />

$30<br />

B. Postage and Handling See Chart<br />

C. Sub-total Brochures, postage and handling (A+B)<br />

D. GST (or HST in NF, NS,NB) on sub-total C<br />

E. Provincial Sales Taxes on sub-total C (in BC, MB, ON, SK)<br />

F. Provincial Sales Taxes on sub-total C+D (in PEI and PQ)<br />

TOTAL – Brochures, postage, handling and taxes (C+D+(E or F)<br />

CDA GST/HST 10684-5209<br />

CDA is grateful to Colgate-Palmolive Canada Inc. for its generous support. Orders can be faxed to CDA toll free at 1-877-523-7736.<br />

For more information, call CDA at 1-800-267-6354.

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