KIT ORDER FORM (Printable) Bonding with Baby® Year 1 Literacy Kits For Institutional Educators, Providers or Libraries ONLY
Developing Hearts Kit Order Department 2048 Elm St. Stratford,CT 06615
NOTE: THESE MATERIALS ARE OFFERED ON A DISCOUNTED, ALL-PROCEEDS-TO-CHARITY BASIS. ONLY INSTITUTIONS, ORGANIZATIONS OR INDIVIDUALS DEDICATED TO CHILD OR FAMILY WELFARE OR SERVICES CAN PURCHASE AT THESE PRICES. (Not for resale and subject to verification.) Name: ______________________________________________________________________________ Title: ________________________________________________________________________________ Organization__________________________________________________________________________ Type: Education__ Provider__ Library__ Other__________ Phone: ______________________________________Email____________________________________ Address: _____________________________________________________________________________ City/Town:______________________________ State________ ZIP_____________________________ Would you like us to add you to our email list to receive updates on Bonding With Baby? ___ Yes __ No __ Currently serving infants? Yes ___ No___ Describe How Serving Infants: ___________________________ ____________________________________________________________________________________ Ship to: (If different from above) __________________________________________________________________ Address: _____________________________________________________________________________ City/Town: ______________________________State: __________ ZIP: ___________________________
BONDING WITH BABY® KIT ITEM
PRICE
+SHIPPING
Book Rate 2-3 weeks 1st Class 2-3days
QUANTITY ORDERED
SUBTOTAL
Single Kit: 1 Video and 4-book Series #1 Parent Education Video Only (English/ Spanish) Five Kits - 5 videos and 5 4-book series ($18 per Kit) Five Sets (5) 4-book series ONLY ($9 a set-no video) Twenty-Five Sets (25) 4-book series ($8 a set - no video) Twenty-Five (25) Parent Videos ($8 per video - no books) TOTAL
$10 $10 $90 $45 $200 $200
or $5 or $5 or $15 or $17 $25 Ground Freight Only $20 Ground Freight Only
$3 $3 $10 $12
X X X X X X
$ $ $ $
$
(100 or more -- please inquire for pricing) To Order on the web go to: www.bondingwithbaby.org. (Tell agent is Institutional Kit order and supply agent above information) Credit Card Information: ___ MasterCard ___ Visa ___ AMEX ___ Discover Credit Card Number: ______________________________ Expiration Date:_________ Authorized Signature: _____________________________________________________ Purchase Order # _______________________ (submit on organization letterhead)
Make check or money order payable to: Developing Hearts Kits. Enclose check with complete order form in S.A.S.E.
SEND TO: Developing Hearts, Kit Order Department, 2048 Elm St., Stratford, CT 06615 Go to Bonding with Baby Site Home