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To place an order, print off this form, complete all fields, and mail with your check or money order to:
Richard S. Ellerby, Ed.D.
2125 Essex Court
Fort Collins, CO 80526
U.S.A.
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Number of books desired: ______ |
x $12.95 = |
$ _______ |
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plus shipping and handling |
$2.00 per book = |
$ _______ |
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Number of special draft editions: ______
"A Differentiation Kindergarten Curriculum:
Applicable to Title I and Special Education," |
x $4.00 = |
$ _______ |
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Total = |
$ _______ |
| Shipping Information |
| Name: | _________________________________________ |
| Address: | _________________________________________ |
| City, State Zip: | _________________________________________ |
Phone number:
(for questions
about the order) | _________________________________________ |
E-mail address:
| _________________________________________ |
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