National Child Care Systems, Inc.
Childcare Courseware Mail Order Form
Please place an "x" by your center type: Day care facility___ In-home center____ After care program_____ Group facility_____ Family Facility_______
Order Date:____________________
School Name:___________________________________________________________________________
Contact Name:______________________________ Position:_____________________________________
Street Address:__________________________________________________________________________
City:__________________________State:_______ Zip Code:_____________________________________
Phone:( )_____________________________ Fax:( )________________________________________
Email Address:__________________________________________________________________________
Test Packages
Courses are sold in packages and will initially require the purchase of the CD-ROM training disk. Additional courses without the purchase of the CD-ROM can be made at the package rates listed below. After purchase of the CD-ROM add the number of tests required. Test packages include course test sheets and certificates. There are no additional fees. Each CD-ROM is $79.
- 50 tests or more: $6 per course, per teacher/BIGGEST DISCOUNT
- 17-49 tests: $10 per course, per teacher
- 1-16 tests: $12 per course, per teacher
If you need additional help on how to order see the "Home Page" on website for instructions
Please Mark Method of Payment
Please make check or money order payable to: National Child Care Systems. Please mail this forms to: P.O. Box 228, Herndon, VA 20172-0228.
Number of courses ordered: __________
X Fee per course( see above):_________
Number of CDs X $79:_______________
Total Amount Due: $_______________ (If using credit card this amount will be charged to card)
Check:____ Money Order:___ Master Card:___ Visa:___ Discover:___
Credit Card #:_________________________________________ Expiration Date:_____________________
Authorized Name on Credit Card (Please print): ________________________________________________
For orders by phone please call 1-800-477-4975.
Please mention coupon code:___________
Thank You For Your Order!!!
