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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__________________ @ $13.95 = $_______________

Keepsake Envelope______ @ $1.00 ea. = $_______________

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

Shipping and Handling                            $_______________
(See chart at right)

TOTAL $____________          

Thank you
for ordering...

Quantity Discount
50 .  .  .  .  .$ 13.50
100 .  .  .  .  .$ 13.00

Shipping and Handling
1 Book $ 3.13
2 Books $ 3.47
3 Books $ 3.81
4 Books $ 4.15
5 Books $ 4.49
Ph: 319-365-3454 or E-mail 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.