Printable Mail Order Form

Please print this form directly from your browser.

Fill out the appropriate information and mail to Brighter Learn at the address shown below.

Please be sure to PRINT CLEARLY to avoid errors. If you make an error, we will reprint for a lesser cost. If

Brighter Learning makes an error (with the correct information being on the order form), we will reprint for no additional cost.

If the name or any other information is unique, please make a special note. Name spellings (Chris vs. Kris;

Maryann vs. Mary Ann; or Sherry vs. Sherri) can be confusing and may cause your order to be delayed.

Please note same considerations when using a nickname.

We can only accept checks drawn on a U.S. bank, and we can only ship to U.S. addresses.

My Baby Book Order Form: Please use Separate Order Forms for Each Book

Options: Language:

____ Two Parent Version ____ English

____ Single Mother Version ____ Spanish

____ Single Father Version

Child's Information:

First Name: ________________________________________________________________________

Nickname: (Optional: after 1st page, will be used throughout book) _______________________________

Middle Name: (Optional) _______________________Last Name: ____________________________

Boy____ Girl ____ Hometown: ____________________________ State: ____________________

Three 1. ___________________________________________

Friends, 2. ___________________________________________

Relatives, or Pets 3. ___________________________________________

Dedication: (ex. With All Our Love, Congratulations, etc.) ________________________________

This Book is From: __________________________________________________________________

Date: (Optional: ex. May, 2001) _____________________________________________________________

******************************************************************************************************

Additional Information for My Baby Book (Optional)

Date of Birth: ___________________________ Time of Birth: _______________________ A.M / P.M.

Baby's Weight: _____________________ (pounds/ounces) Baby's Length _________________ in.

Delivered By: _____________________________ Hospital: ___________________________________

Mom's First Name: _________________________ Dad's First Name ____________________________

ORDER TOTAL (REMEMBER, ONLY ONE BOOK PER ORDER FORM; HOWEVER, YOU MAY ORDER A LETTER ON THE SAME FORM):

Cost of Item(s)	$ ___________	($9.95 / $12.95 / $14.95 / $2.00 (letter price includes postage))
Photo Sticker	FREE
Discount	$ ___________	(See Discounts - always 20% on order of 3 or more books)
Subtotal	$ ___________
Tax	$ ___________	(See Tax table below)
Shipping/Handling	$ ___________	($2.00 for each book)
Total Order Price	$ ___________

Tax:
	Colorado Resident (non-Teller County).............................................	2.9% tax
	Colorado Resident (Teller County, non-Woodland Park City)......	3.9% tax
	Colorado Resident (Teller County, Woodland Park City)................	6.9% tax

CUSTOMER INFORMATION:

Today's Date: ____________________

Customer'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).

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:

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

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