School Mediation Associates

School Mediation Associates Order Form

This form is not for ordering on line. Print the form out, fill it in, and fax or post it back to us.
Or you can order books by phone by calling us toll free at 800-833-3318.

Please Send:
 ___ copies of The School Mediator's Field Guide at $24.95 per copy    ______
 
 ___ copies of Students Resolving Conflict at $19.95 per copy          ______ 
    
 ___ copies of Mediation: An Alternative That Works Video at $29.95    ______
     Please circle your preferred video format,  DVD or VHS tape

 ___ Information about School Mediation Associates                     _Free_       
                            
                                                         Subtotal:     ______
  Sales Tax:
  Please add 5% for books shipped to Massachusetts addresses           ______
    
  Shipping:
  Within the United States:  
  $4.50 for first book/video; $2.50 for each additional book/video

  Outside the United States: Postage costs and currency exchange
  fees vary widely (and are often quite expensive).
  Contact us at sma@schoolmediation.com for more information.          ______
                                                            
                                                            Total:     ______              
  (All orders should be paid in US dollars.)

  Payment (check one):
  
   __ Check enclosed (Made out to "School Mediation Associates")
   
   __ Bill my school (must include PO #) PO #: ______________
   
   __ MasterCard
   
   __ Visa      
   
      Credit Card #: _________________________
      Expiration Date: __________
      Cardholder's Signature: ____________________________

Name: ___________________________________________________________

School Name: ____________________________________________________

Address (home or school): _______________________________________

City: _____________________________  State: ______  Zip: ________

Telephone: ____________________      Fax: _______________________

Email:  _________________________________________________________

I would like to receive The School Mediator, a free monthly EMAIL newsletter?______
(We need your EMAIL address in order to send the newsletter to you!)

How did you first learn about our materials:  _____________________________________