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To order, print this form, complete and mail to:
Adoption World Specialties Ltd.
Dept. I-N
6920 Wilton Dr. NE
Cedar Rapids, IA 52402

Name: _______________________________________________

Agency: ______________________________________________

Address: _____________________________________________

City: _________________________________________________

State: ________________    Zip:__________________________

Phone: (        )_________________________________________

Fax: (        )___________________________________________

E-Mail: ______________________________________________

Quantity___________________ @ $14.95/Kit = $____________

Adoption Chapters______ @ $3.95/Chapter = $____________

Iowa Residents add 5%                   $_____________________
(6% if local option tax applies)

Shipping and Handling                   $_____________________
(See chart at right)

TOTAL $_________________       

Thank you
for ordering...
Kit B - Foster

Quantity Discount
for pre-paid orders of 100 or more.
E-Mail for information.

Shipping and Handling
1 Kit $ 3.44
2 Kits $ 3.93
3 Kits $ 4.57
4 Kits $ 5.63
5 Kits $ 6.43
Ph: 319-365-3454 or E-mail
(lovekids@adoptionstuff.com)
for quote on larger quantities or PRIORITY shipment.

Free "Adoption Language Guide" with any order over $5.00

Click Image for larger view
 Check Enclosed:______     Charge to:_____     _____

Carefully write your Account Number:
    
    
    
    

Exp. Date__________

Authorized Signature_______________________________________
Sign exactly as name appears on card.

Please e-mail (lovekids@adoptionstuff.com) or call our sales department at (319) 365-3454 for further questions. For orders outside the U.S., please contact us at (319) 365-3454 or by e-mail before ordering.

All prices and shipping rates are subject to change.