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Order Form

Checks and Purchase Orders, along with this form, can be sent to:

Ellar Software for Learning
6342 West Lake Drive
Alexander, AR 72002
PHONE: 501-912-6569

TOLL-FREE FAX: 1-866-753-5297

Please list the product name/offer and price as listed. Please add $4.95 per product
for shipping and handling. Products will be sent via USPO unless other arrangements
are made with us.

Product ....................................................................... Price $....................

Product ....................................................................... Price $....................

Product ....................................................................... Price $....................

Product ....................................................................... Price $....................

Product ....................................................................... Price $....................

Product ....................................................................... Price $....................

Product ....................................................................... Price $....................

Shipping ($4.95 per product)..................................................$....................

Total:                                                                          $_________________

Your Name___________________________________

Ship to: Person or Department____________________________________

School/Institution if applicable_____________________________

Address____________________________________

Address____________________________________

City/State/Zip________________________________

Email address: __________________________________

Schools/Institutional purchases
Your Title__________________
Purchase Order Number (if applicable) _________________