National Consortium for State Guidance Leadership, Product Order Form

5380 Ocean Drive Suite 6D Singer Island FL 33404 Email: Drierh@aol.com Fax: 561.844.3082

Date:	mo/day/year xx/xx/xxxx	ORDERING INSTRUCTIONS Orders should include achool/agency purchase order/number or pre-payment. Duplicate orders not marked Confirming are the responsibility of the purchaser. Expect delivery of materials within 7-14 days after receipt of order. Report discrepancies within 30 days. All returns require written authorization.
Order placed by*:
Phone No*:	daytime xxx-xxx-xxxx
Fax*:	xxx-xxx-xxxx
Email*:
Bill to Agency*:		STANDARD DISCOUNTS On orders of at least 10 items with a total dollar value of: $201 to $300, the discount is 5% $301 to $400, the discount is 10% $401 & above, the discount is 15%
Name/Title*:
Address*:
City*:
State/Zip*:
Ship to Agency*:		SHIPPING /HANDLING For orders up to $50 …… add $5.00 For orders over $50 …… add 10% For orders over $200 …… add 10% or call for best price Priority and international shipments are charged at actual costs plus a $10.00 handling fee.
Name/Title:
Address*:
City*:
State/Zip*:
	*=required fields	Grey boxes will be calculated. Do not fill in grey boxes.

Catalog Number*	Quantity*	Product Title*	Unit Price*	Extended Price






PAYMENT Payment must accompany personal orders. due 30 days after receipt of materials and		On school/agency orders, payment is invoice, payable to The CETA Corp.
Payment Method:
			sub-total $
School/Agency PO #*		Less Discount%
Check # For $		Add Shipping/Handling $
MoneyOrder# $		Total Amount Due $
		Click "Calculate" button for totals

Thank you for your order!
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