Print and fill out this form
Name __________________________________________________
Address (Line 1) __________________________________________
Address (Line 2) __________________________________________
City ___________________________________________________
State and Zip ___________________________________________
Phone (________) _________________________
School P.O. # ___________________________________________

QTY ITEM PRICE TOTAL
________ Classroom Kit $136.95 $ __________
1 CD
30 Story Books (5 of each)
________ Teaching Kit $40.95 $ __________
1 CD
6 Story Books (1 of each)
________ Student-Books & Big Books $14.99 $ __________
       Pattern Packet
________ CD $16.95 $ __________
________ Set of 6 Story Books (1 of each) $24.00 $ __________
________ Individual Story Books (note quantities below) $4.00 each $ __________
_______ Down at the Pond _______ In the Deep Blue Sea _______ "What's All the Fuss?"
_______ The Indian's Week _______ Jelly Beans & Gummy Things _______ Here Kitty, Kitty!
                                                 Shipping $ 3.99
                                                 Sales Tax (GA Residents Only) 6% $ __________
Total $ __________
                                                  
Call... or Fax to... or Mail to...
(770) 367-7978   (770) 924-8748   Periwinkle Park Educational Productions, Inc.
3217 Eagle Watch Drive

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Woodstock, GA 30189