Take Care: A Devotional for Caregivers
Personalized Autographed Book Order Form -The cost is $20 for an autographed book that will be mailed to you. A portion of the proceeds are going towards gifts for caregivers. For orders of 5 or more, please note in the comment section below.
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Email *
Full Name (Mailing Address where book will be delivered.) *
Street Address (P.O. Box) *
City, State and Zip code *
Number of books (All will be mailed to address above) 1=$20, 2=$30, etc  (Please note if you are ordering multiple books for an author discount.) *
Write the name(s) and message the book will be dedicated to... *
Write the name(s) and message the book will be dedicated to...
Telephone number (in case there is a challenge) *
Would you like to receive updates or be invited to future events? (Your information will NOT be given to third parties.) *
Form of payment... (Please type name in comment box) *
Comment/ Note: (Orders of 5 or more with receive a discount)
A copy of your responses will be emailed to the address you provided.
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