2002 LDR Order Form

Ordering Instructions: 
1) Please identify the four digit item number when placing orders.
2)  Orders can be placed by printing the following form and then sending it by mail, e-mail or fax.
 3)  Orders can also be made by phone.  800-869-8336
 4)  Purchase orders are accepted by mail, e-mail or by phone. 
 5)  Payment can be made by check, money order or credit card (Visa, Master Card or American Express).

 

Mail Orders to:  Learning disAbilities Resources  610-446-6126    Our Federal Id Number is
P.O. Box 716 Fax 610-446-6129  23-2526549
Bryn Mawr, PA 19010 [email protected]

Name  __________________________________________________________      

Phone  ________________________________________________

Agency (if any)  __________________________________________________

Purchase Order Number  ________________________________

Address  ________________________________________________________

Credit Card Purchase:  Exp. Date   ________________________

City  ________________________________  State  _____   Zip___________

Visa or MC # ___________________________________________
Credit Card Signature ___________________________________
If ordering a Tee Shirt  (Tee Shirt Size:  S    M    L    XL )

 

     Quantity            Item Number                                                         Description                                                           Cost Each                      Total

         
         
         
         
         
         
         
         
         
         
         
         
         
         
         
         
         
   
Shipping and Handling
Order      $1.00 to $5.00                         $1.00                                                       Subtotal
Order      $5.01 to $10.00                       $2.00      
Order      $10.01 to $30.00                       $4.00                                                      Tax (when applicable) 6% in PA                  

Order      $30.01 to $50.00                       $6.00                                                       Shipping and Handling                       

 
Order      $50.01 to $100.00                     $8.00                                                       Donation to the Center for  

Order      $100.01 to $200.00                  $10.00                                                                     Alternative Learning                

Order      $200.01 to $300.00                  $15.00

 

Order      $300.01 to $500.00                  $18.00

Order      $400.01 to $500.00                  $20.00
Order      $500.01 or more                       6% of order total                                         Total