| Order
Form for 5 Minute Kids™ |
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| Shipping
Information: |
Name: |
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Address: |
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City/State/Zip: |
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Phone: |
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| Item |
Unit price |
Quantity |
Total price |
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| 5-Minute
Kids™ Manual |
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$30.00 |
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| 50 Goal/50 Homework Stickers |
$5.00 |
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| 100
Goal stickers |
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$5.00 |
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| 100 Homework stickers |
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$5.00 |
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| 100 Goal/100 Homework stickers |
$8.00 |
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| 48
Medicaid Stickers |
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$3.00 |
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Shipping |
FREE |
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Total |
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Send Payment to: |
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Sue Sexton |
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3580 Crestwood Dr. |
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Lapeer, MI 48446 |
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810-664-5388 |
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FAX 810-356-5445 |
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speechlady@charter.net |
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| Visit us at: www.5minutekids.com |
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| 8/1/2008 |
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Accepting Visa and
Mastercard |
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