PALS Order Form

P.A.L.S. ORDER FORM

Two Ways to Order...
Mail - For prepaid orders and purchase orders, fill out the form below, print it off and send it to us. Include check, money order or purchase order information. Include tax exempt number. (Orders by individuals must be pre-paid.) Mail your order to: Mid-Minnesota Women's Center P.O. Box 602, Brainerd, MN 56401-0602
E-mail or FAX - For purchase orders only. Complete the form below and fax or hit Submit button to e-mail it to us 24 hours a day, 7 days a week. Include purchase order information. Our fax number is 218-828-1216.

School/Organization/Other	Name

Position	Address

City State Zip

Phone	Email


Purchase by
School District Organization Individual

Method of Payment
Check-Money Order Purchase Order Order Number
Tax Exempt Number
Products

TeacherPALS, PrinciPALS and I to I - $119.00
Quantity Total

6 TeacherPALS (grade K-5), PrinciPALS, and I to I - $312.00
Quantity Total
Free with order: T-Shirt or Parent Guide

TeacherPALS - $45.95
Quantity Total

PrinciPALS - $12.34
Quantity Total

Eye to Eye Training Video - $80.00
Quantity Total
KidPALS - Primary Edition
1-49 Copies - $3.45 each Total 50-99 Copies - $3.20 each Total 100+ Copies - $2.95 each Total

KidPALS - Intermediate Edition (Blackline Master) - $29.95
Quantity Total
Resolve it! Parents Guide
1-12 Copies - $6.95 each Total 13-24 Copies - $6.60 each Total 25-49 Copies - $6.27 each Total 50-99 Copies - $5.95 each Total 100+ Copies - $5.67 each Total

T-Shirts - $12.00 each
Small Midium Large XL Total

Subtotal All Orders
6.5% Sales Tax (MN Only)
Tax Exemption Number
Shipping & Handling	Shipping & Handling Charges (Continental U.S. Only) Orders upto $25 add $3.00 , Orders $25.01 to $50 add $6.00 Orders $50.01 to $100 add $10.00, Over $100 add $12.00
TOTAL