Order form for 5 Minute Kids™

 

 

Shipping Information:   Name:___________________________

 

                                                Address:_________________________

 

                                                City/State/Zip_____________________

 

                                                Phone:__________________________

 

 

Item

Unit Price

Quantity

Total Price

5 Minute Kids™Complete Kit*

$35.00

 

 

100 Goal stickers (10 sheets)

$3.00

 

 

100 Homework stickers (10 sheets)

$3.00

 

 

48 Medicaid stickers (2 sheets)

$1.00

 

 

 

 

Subtotal

 

 

 

Shipping

FREE

 

 

Total

 

*Complete kit includes 50 homework/goal stickers and 48 Medicaid stickers

 

 

 

 

 

 

                                     Send Payment to:

 

                                                                   Sue Sexton

                                                                   3580 Crestwood Dr.

                                                                   Lapeer, MI  48446
                                                                   810-664-5388

                                                                   FAX: 810-356-5445

                                                                   speechlady@charter.net

7-1-07