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Brighter Learning Personalized Book

To:  __________________________           From: __________________________

Message: __________________________________________________________
___________________________________________________________________
___________________________________________________________________

PLEASE CHOOSE ONE BOOK PER ORDER FORM - you may order a letter with a book on same form.
    LANGUAGE
English Spanish
BOOK TITLES
      LANGUAGE
English   Spanish   
BOOK TITLES
___Eng  ___Spa
___Eng  ___Spa
___Eng
___Eng  ___Spa
___Eng
___Eng
___Eng  ___Spa
___Eng  ___Spa
___Eng  ___Spa
___Eng  ___Spa
___Eng
___Eng  ___Spa
___Eng  ___Spa
___Eng

  My Baby Book                       
  Flintstones          
  Scooby-Doo           
  Spider-Man     
  SPY kidsTM                  
  The Looney Tunes
  Where's Waldo                        
  Batman              
  My Day on Sesame Street
  Sesame Street: Let's Count             
 Sesame Street: ABC and Me    
  Superman & Wonder Woman        
  X-Men                       
  African-American Heroes                  
 African American Santa Letter
  Caucasian Santa Letter
  Easter Letter
___Eng
___Eng
___Eng  ___Spa
___Eng  ___Spa
___Eng  ___Spa
___Eng  ___Spa
___Eng  ___Spa
___Eng  ___Spa
___Eng
___Eng  ___Spa
___Eng  ___Spa
___Eng  ___Spa
___Eng
___Eng  ___Spa
___Eng
___Eng  ___Spa
___Eng  ___Spa
___Eng  ___Spa
___Eng  ___Spa
___Eng  ___Spa
___Eng  ___Spa
___Eng  ___Spa
___Eng  ___Spa
  African-American Santa
  Ballerina Princess
  Baby Jesus                       
  Beauty and the Beast                         
 Circus Star:Birthday at the Circus
  Circus Star:Circus Party                    
  Dinosaur Land                       
  Farm Animals            
  Football Star            
  G-o-o-oal!: A Soccer Story               
 Jesus the Provider                       
 Jewish Holidays                       
  Kwanzaa
  Little Mermaid                       
  Mother Goose
  Ninja Adventure                       
  Noah's Ark                       
  Santa                       
  School is Fun                       
  Sports Superstar                       
  Teddy Bear Land                 
 Three Little Pigs                       
  When I Grow Up    

PERSONALIZED INFORMATION:
Please Enter Information as it will be
PRINTED IN THE BOOK
PLEASE PRINT CLEARLY
FIRST NAME: ___________________________________________
NICKNAME:  ____________________________________________
(optn'l.: after 1st page, program uses nickname throughout book)
MIDDLE NAME: (optional)  ___________________________________
LAST NAME:  ___________________________________________
AGE: (optional) ______________________                 BOY   GIRL
HOMETOWN: ________________________STATE______________
Three
1: _________________________________
Friends,
2:   ________________________________
Relatives or Pets
3:  _________________________________
MESSAGE (ex. With Love From, Happy Birthday, etc.):________ _______________________________________________________
THIS BOOK IS FROM:_____________________________________
DATE (optional: ex. May 2000) _____________________________
Additional information for My Baby Book ONLY

English
Spanish
  Two Parent Version


  Single Mother Version


  Single Father Version



DATE OF BIRTH:  _____________ TIME OF BIRTH:_________  AM  PM
BABY'S WEIGHT:  ___________ pounds  __________ ounces
BABY'S LENGTH: ______________ inches
DOCTOR'S NAME: __________________________________________
HOSPITAL:  _______________________________________________
FIRST NAME: __________________ MOM____________________DAD

Additional  info. for Football Star or Soccer ONLY
FAVORITE PLAYERS:  ________________________________________
TEAMS: ____________________WINNING _________________LOSING

Additional information for School is Fun ONLY
TEACHER:  _________________________________________________
SCHOOL:  __________________________________________________


PURCHASER'S INFORMATION:

Today's Date: ____________________
Purchaser's Name: ______________________________________________
Address: __________________________________________________________________________
City: ___________________________________   State: _____________________  Zip: ___________________
E-Mail: _________________________________  Phone (Day): ___________________  (Eve): __________________
(e-mail and/or phone is required if it becomes necessary to verify spelling of names or ask other questions.  As always,
your e-mail and/or phone will NOT be sold, traded or given to another party).

Recipient:  Would you like to be put on our Mailing List?  Yes ______    No _____  
If yes, please provide address or e-mail
Purchaser: Would you like to be put on our Mailing List?  Yes ______    No _____

SHIPPING INFORMATION (IF DIFFERENT THAN ABOVE):

Name: ______________________________________________
Address: __________________________________________________________________________
City: ___________________________________   State: _____________________  Zip: ___________________
E-Mail: _________________________________  Phone (Day): ___________________  (Eve): _________________

BILLING INFORMATION:  See Pricing Information Under Printable Order Form

Purchaser:   Form of Payment
___ Check
___ Money Order
PLEASE MAIL THIS FORM ALONG WITH PAYMENT TO:
(MAKE CHECK OR MONEY ORDER PAYABLE TO:)
Brighter Learning
181 Honey Hill Lane
Woodland Park, CO  80863
719-687-0437
smarshall@brighterlearning.com
Call/E-mail for FREE Descriptive Brochure