Churches Only - ordering info

To pay by check, print this page then complete the form and mail.

1. Complete this form. (personal information will never be sold)
2. Enclose payment * (U.S.) according to bulk order information found below.
Checks are made payable to: J. Wylie Hartwell
3.
Mail to:   J. Wylie Hartwell
                    P.O. Box 65995
                    Orange Park, Florida 32065

Number of booklets: _________ X cost per booklet * __________ = _____________

Full Name: __________________________________________________________

Mailing Address: ______________________________________________________
___________________________________________________________________
___________________________________________________________________

Contact person and Phone #: _____________________________________________

Sales Tax exempt number—Florida churches only: _____________________________

E-Mail Address: _______________________________________________________

Shipping info only if different from above:
Full Name: ___________________________________________________________

Mailing Address: ______________________________________________________
___________________________________________________________________

How did you hear about Kid Safe Cyberspace? ___________________________
__________________________________________________________________

*Bulk order information: (church rate)
Minimum order of 100 booklets

All must ship to the same address:
Prices include shipping within the U.S.
For shipments to other countries,
please Email us at:

100 – 200 @ $0.79 each
201 – 600 @ $0.69 each
601 – 1,200 @ $0.59 each
1,201 – 2,000 @ $0.49 each
2,001 – 4,999 @ $0.39 each
5,000 + booklets require a special quote, please Email us.

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