Print Order Form

It's easy to order!

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Download this form (PDF)

We accept VISA and MasterCard.

ORDERING BY MAIL OR FAX, PLEASE PRINT THIS PAGE AND MAIL OR FAX TO:

Program Development Associates
ATTN: ORDER DEPARTMENT
32 Court St., 21st Floor
Brooklyn, NY 11201
Call 800-876-1710 or Fax 718-488-8642

SHIP TO (Sorry, We Cannot Ship to P. O. Boxes):
Contact_Name___________________________________________ Title___________________________________________________ Organization____________________________________________ Address_______________________________________________ City___________________________________________________ State_________ZipCode_______ Phone(____)________________________________ Fax(____)__________________________________

End User___________________________________ Email________________________________________________ (Include Email Address for FREE Disability Internet Newsletter)

BILL TO:
Contact_Name_________________________________________ Title_________________________________________________ Organization___________________________________________ Address______________________________________________ City__________________________________________________ State_________ZipCode_______
Phone(____)________________________________
Fax(____)__________________________________

Payment Policy

Payment must accompany all mail-in orders unless covered by an organizational purchase order with Payment Due Net 30 Days. Prices subject to change without notice. All orders must be paid in U.S. Dollars!

METHOD OF PAYMENT:
Purchase Order Number___________________________
___I've Enclosed Check # ______________ Payable to Program Development Associates
___Credit Card - Charge my order, plus shipping and handling to my credit card.

___ MasterCard
___ VISA

Exp. Date ________________________ Security ___________
Card_Number__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__ Card_Holder_Name______________________________________
Signature______________________________________________

Order Chart

To Calculate correct shipping charges when ordering specials or series, each item must be counted individually.

Quantity    Resource #       Title                                    Price

________|____________|_______________________|_________ ________|____________|_______________________|_________ ________|____________|_______________________|_________ ________|____________|_______________________|_________ ________|____________|_______________________|_________ ________|____________|_______________________|_________ ________|____________|_______________________|_________ ________|____________|_______________________|_________ ________|____________|_______________________|_________ ________|____________|_______________________|_________

Subtotal _____________

NY  & IL State Residents Add Sales Tax or Tax Exempt Certificate__________

Shipping and Handling *: $10.00 first item, $4.00 each add'l item: __________

TOTAL ____________

* S/H fees for 48 contiguous states only.  AK, HI and Canadian orders include an additional $15.00.  All other orders please inquire.

ALL ORDERS MUST BE ACCOMPANIED WITH PAYMENT OR OFFICIAL AGENCY PAYMENT AUTHORIZATION.

30-DAY MONEY BACK GUARANTEE! If you're not satisfied with a video, CD-ROM, or book purchase, return it for an exchange or full refund, excluding shipping and handling, with 30 days of the shipping date. Items must be returned in original packaging with shipping prepaid. Include a copy of your invoice or packing slip to insure proper credit.

SHIPPING: We typically ship by UPS ground. We cannot ship to P.O. Boxes using UPS services so please call for other arrangements. We will attempt to process and ship your order within 3-5 working days after receipt of order. However, out-of-stock items may take a little longer. If you need rush delivery, please specify and we will do our best to accommodate your request.

COPYRIGHT - These resources are protected under the U.S. and all applicable copyright laws.  The duplication, telecasting, cablecasting, or broadcasting of these programs or any part thereof, for any reason whatsoever, without the express prior written consent of the copyright holder constitutes a violation of federal law. Please note that not-for-profit institutions are not exempt from the provisions of the Copyright Act.