# ORDER FORM

**Name** __  
**Savings code** __

**Address** _____  
**City** ____  
**State** ____  
**ZIP** ____  
**Country** ____

MAIL form to Brookes Publishing Co.  
P.O. Box 10624; Baltimore, MD 21285-0624

**Phone** ____  
**Email** ____

m Yes! I want to receive email about new titles & special offers. (Your email address will not be shared.)

### PHONE 1-800-638-3775

### Specialty:  
m Birth to Five   
m K–12   
m Clinical/Medical Personnel   
m 4-year College/Grad.   
m Comm. College/Vocational   
m Association/Foundation   
m Community Services

| Stock # | Title | Qty | Price |
|---------|-------|-----|-------|
| ---     | ---   | --- | ---   |
| ---     | ---   | --- | ---   |
| ---     | ---   | --- | ---   |
| ---     | ---   | --- | ---   |

### PAYMENT METHOD  
m Check enclosed (payable to Brookes Publishing Co.)  
m Credit card

**Product subtotal (in U.S. dollars)**  
m Purchase Order (bill my institution—P.O. MUST be attached)*  
**Credit card account number** ____ ____ ____ ____ ____  
m Credit card  
**Shipping (see chart)**  
**State sales tax (US residents)**  
or **GST (CAN residents)**  
**Security code (3 or 4 digit code on back of card)** __ __ __ __  
**Grand total**  
**Expiration date** ____/____  
**Signature** ____

* We reserve the right to add an additional 2% order processing fee on all orders that require special processing.  
**Sales tax**: To see if your state is on the list for sales tax, visit [Sales Tax Info](https://www.brookespublishing.com/tax/). Canadian residents: please add your GST. Sales tax should be calculated based on the total order (including shipping) in U.S. dollars. If sales tax is calculated incorrectly, Customer Service will correct it prior to processing your order and the adjusted total will appear on your invoice.

### STANDARD GROUND SHIPPING & HANDLING
(For other shipping options and rates, call 1-800-638-3775, in the U.S.A. and Canada, and 410-337-9580, worldwide.)

**Shipping Rates**  
**U.S.A., territories & protectorates**  
For subtotal of  
**$50.00 and under** $6.50

**Canada***  
For subtotal of

Australia, New Zealand, Fiji, Papua New Guinea, Tonga, Solomon Islands, and Cook Islands: Woodslane Pty Ltd | 10 Apollo St, Warriewood NSW 2102, AUSTRALIA | Tel: 61-2-8445-2300 | info@woodslane.com.au |  www.woodslane.com.au

**Send orders to the companies listed**  
Africa, Asia, Continental Europe, Middle East, and UK: Eurospan | Gray’s Inn House, 127 Clerkenwell Road, London, EC1R 5DB, UK Trade Orders & Enquiries: Email: trade.orders@marston.co.uk  | Tel: +44 (0)1235 465576 Individual Orders & Enquiries: www.eurospanbookstore.com/brookes | Email: direct.orders@marston.co.uk |  Tel: +44 (0)1235 465577