BATES PUBLISHING ORDER FORM PLEASE PRINT, FILL OUT AND EITHER MAIL OR FAX FORM: Bates Publishing Suite# 5, 11 Jan Sebastian Way Sandwich, MA 02563 Tel: 1-508-833-5096 / Fax: 1-508-833-6284

PURCHASE ORDER # _______________________________________ PREFERRED METHOD OF SHIPMENT: UPS USPS PRIORITY MEDIA OTHER__________ CHECK ENCLOSED PHONE # _________________________________________________

BILL & SHIP TO: ________________________________________________________ School Name ________________________________________________________ Attention ________________________________________________________ School Address ________________________________________________________ City/State/Zip

SHIP TO: (If different from bill to") _________________________________________________________ School Name _________________________________________________________ Attention _________________________________________________________ School Address _________________________________________________________ City/ State/Zip

ISBN Number ___________________________ ___________________________ ___________________________ ___________________________ ___________________________ ___________________________ ___________________________ ___________________________ ___________________________

Description / Title ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________

Quantity ________ ________ ________ ________ ________ ________ ________ ________ ________

Price ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________

Total ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________

Note: Shipping and handling charges are additional and figured at current rates from our shipping point. Charges are prepaid and added to your invoice as a separate item. If payment for educational materials is enclosed with your order, please add 9% or $5.00, whichever is greater, to cover transportation and handling costs. PRICES ARE SUBJECT TO CHANGE WITHOUT NOTICE.

Total

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