-----Order Form-----
Please print this form, fill it out,
and mail it with your payment to complete your order.

**Make Checks or Money Orders Payable to:  Joe Tompkins

Send this completed form with payment to:
Joe Tompkins
130 Wintergreen Ct
Covington, GA 30016

Your Name___________________________________________

-or-
School Name__________________________________________


Email Address 
(to receive registration code via Email-- Allow 1 week for reply):

_____________________________________ 


Mailing Address 
(to receive registration code via postal mail-- allow 5 weeks for reply)
-United States Addresses ONLY-- All others will receive code via email-

Street:______________________________________________________________

City___________________________State_________ Zip____________________


Please indicate the product(s) you wish to register below:

_____________________________________________________________________
Product:			   |Quantity|   Unit Price   | Total |
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Vocab-Flash (Single User)	   |	    |   $10.00 (US)  |	     |
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Vocab-Flash (Site License)	   |	    |   $50.00 (US)  |	     |
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StoryMaker (Single User)	   |	    |   $10.00 (US)  |	     |
----------------------------------------------------------------------
StoryMaker (Site License)	   |	    |   $50.00 (US)  |	     |
----------------------------------------------------------------------
Activity Maker (Single User)	   |	    |   $10.00 (US)  |	     |
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Activity Maker (Site License)	   |        |   $50.00 (US)  |	     |
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Kid Cards (Single User)		   |        |   $10.00 (US)  |	     |
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Kid Cards (Site License)	   |	    |   $50.00 (US)  |	     |
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Homework Collector (Site License)  |	    |   $30.00 (US)  |	     |
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					Total Enclosed:

