Major Rivers Order Form


Bill To:

Name:

Company/Organization:


Contact:

Address:

City:

State:

Zip:

Phone:

Fax:

E-Mail:

Company/Organization:


Contact:


Address:


City:


State:


Zip:


Phone Number:


Purchase Order (Schools and agencies only) (check one):

Enclosed To Be Sent Not Required

Number (If known):


Imprinting (check one):

Requested Need Information Not Requested

Item:

Class Set:
(for the new teacher)
Contains teacher guide, video cassette, classroom poster, record sheet, and 25 copies of:
student book
pretest
post-test
home activity booklet
badge

Unit Price: $50

No. of Kits Ordered:


Extended Price:


Student Pack:
(to supply teachers with more than one class or to resupply previous year's teachers)
Contains record sheet and 25 copies of:
student book
pretest
posttest
home activity booklet
badge

Unit Price: $40

No. of Kits Ordered:


Extended Price:


Spanish Home Activity Booklets
(set of 25)

Unit Price: $10

No. of Sets Ordered:


Extended Price:


Materials Total:

Total Price of all materials:


Note: The costs for shipping, and, if applicable, imprinting and sales tax (California only) will be added when invoiced.

Payment Method:

Check Enclosed
(Make checks payable and mail this form to address below)
Educational Development Specialists
5318 E. 2nd Street #512
Long Beach, CA 90803
(562) 434-6225 phone

Purchase Order (Fax or submit this form)
(562) 434-7551 fax