Order Form

Take A Stand Program CD/DVD

K-5 School Program includes:

     Parent/Teacher, /K /1/2/3/4/5 materials &     masters for all student and parent handouts

30 Day Preview - No Charge _______________

            $95 each for 1-5 copies _______________

            $75 each for 6 - 10 copies _______________

            $60 each for 11 - 20 copies _______________

             $50 each for 21 + copies _______________

Total Price for copies being ordered: $______________

·  We pay shipping and handling on all prepaid orders. n/c

·  All orders shipped PRIORITY by US Mail

·  S/H - 6% S&H in Continental US or minimum $10 $______________

·  S/H - 10% to Alaska, Hawaii, Puerto Rico and International Orders. $______________

·  Orders in Colorado require tax-exempt number: _______________________

TOTAL $______________

PAYMENT – By Check or Purchase Orders Only

Payments are due in 30 days. U.S. Currency only.

BILL TO:

Name:__________________________________________

Title:___________________________________________

Address:________________________________________

_______________________________________________

City:________________________________State:_______

Country:__________________________ZIP:___________

E-Mail:_________________________________________

Phone _________________Second # _________________

SHIP TO:

Name:__________________________________________

Title:___________________________________________

Address:________________________________________

_______________________________________________

City:________________________________State:_______

Country:__________________________ZIP:___________

E-Mail:_________________________________________

Phone _________________Second # _________________

FAX TO: (303) 320-6328

MAIL TO:

            Coalition for Children

            P.O. Box 6304

            Denver, CO USA 80206

E-MAIL To: Kraizer@safechild.org

If you have any questions, please e-mail or call 303-809-9001

THE FINE PRINT

YOUR COMPLETE SATISFACTION IS GUARANTEED: If for any reason a Program does not meet your needs, simply return it within 30 days for a full refund.

FREE 30-DAY PREVIEW: Programs will be provided for purchase consideration for 30 days at no charge. We will ship the Program along with an invoice. If you decide to keep it, simply pay the invoice. If you decide to return it, ship it back, return receipt requested. We cannot be responsible for lost, uninsured returns. Previews may be extended beyond the 30 day preview period upon request.

CALL: Have questions? 24-HOUR FAX LINE: 303-320-6328. FAST TURN AROUND: Need your materials right away? We ship most orders within 48 hours.

TRAINING: Dr. Sherryll Kraizer, author of the Programs is available to provide on site training. Please contact us for details.

EXTENDED PAYMENT PLAN: Want to place an order, but there's no money left in this year's budget? Talk to us about extending payment into your next fiscal year.

LIFETIME REPLACEMENT: You may replace any component of The Safe Child Program, once you are an owner, at minimal cost. Simply return the damaged or worn out item or contact us to discuss replacement of lost items.

This page is brought to you by the Coalition for Children, Inc., a not-for-profit (501c3) organization.

Contact information:

Sherryll Kraizer, Ph.D., Executive Director

FAX: 1-303- 320-6328

Postal address: P.O. Box 6304

Denver, Colorado, USA 80206

E-mail: Kraizer@safechild.org

Copyright © 1996 -2008 Coalition for Children, Inc., Sherryll Kraizer, Ph.D.