One Hand Typing and Childsize Keyboards Catalog and Order Form

One Hand Typing and Childsize Keyboards Catalog and Order Form Page 6 of 5
Please Fill Out and Return
Is this for a one-handed child, 12 years or under?
Then, you really need a childsize keyboard as well as the one hand typing instruction.
How are you paying for this? Check one:
Check enclosed __ Credit Card Type: Visa__ MC___ Discover___ AmEx. ___
Credit Card #: __________________________________, Exp. Date ______________
Name of person who has authorized this order _______________________
Phone: ___________________________ , Fax _______________________________
PURCHASE ORDERS: We only accept PO from schools and government agencies
PO # ___________________________________________________
If using a PO , include a note on your school’s letterhead, or a purchase order form from your school, or school district.
Payment must be within 30 days. Late fees will be charge at 1.5% per month
Bill to Address and Contact Name:
_____________________________________
_____________________________________
_____________________________________
_____________________________________
Ship to Address and Contact Name:
_____________________________________
_____________________________________
_____________________________________
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Checks payable to Lilly Walters, 740 Purdue Dr . Claremont, California 91711
For questions 909-398-1228, fax orders to 408-228-8752