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: _____________________________________________

Basic Packet Quantity_____ @ $13.70 = $__________

Items Separate

Foster Parent Handbook Qty_____ @ $3.75 = $__________

Childs Booklet Qty_____ @ $4.50 = $__________

Teen Letter Qty_____ @ $1.50 = $__________

Adoption Day Pledge Qty_____ @ $3.95 = $__________

Extras

Social Wrker Chcklist Qty_____ @ $1.00 = $______

Journey to Adoption Qty_____ @ $1.00 = $______

Finalization Day Tips Qty_____ @ $1.00 = $______

Name Change Cards Qty_____ @ $1.00 = $______

Famous Adoptees Qty_____ @ $1.00 = $______

Adoption Day Balloon Qty_____ @ $1.00 = $______

Adoption Announce Qty_____ @ $1.00 = $______

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

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.