– ORDER FORM –

Print & Mail

Les Chemins de ma Vie
[The Roads of My Life]

by Adèle Frigault Mailloux

All profits are donated to the Muscular Dystrophy Association in Montréal

Instructions:
• $13 each (includes shipping)
• Use Canadian check or international money order
• U.S. residents ... be sure to use correct postage to Canada
• Send completed form & payment to:

Adèle Frigault Mailloux
4 Chemin du Quai
St-Fidèle, Charlevoix, PQ, Canada G0T 1T0

Enclosed is $_____.

Please send _____ copy (copies) of Les Chemins... at $13 each.

___ Please autograph my book(s)!

Name _______________________________

Phone _______________________________

Street _______________________________

City ________________________________

State/Prov. ____________   Zip ___________