ORDER FORM FOR "COLORS" & "NUMBERS"  
    (Please note: make check or money order out to Dickson Enterprises Incorporated and not TRAIN YOUR BRAIN, LLC)  
     
  Directions  
  1. Print order form  
  2. Complete Information  
  3. Mail order form with a Check or Money Order to  
     
  Jacqueline Dickson, DEI  
  103 Central Avenue  
  Stirling, New Jersey 07980  
  USA  
     
     
     
 

S H I P    T O :

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

T E L E P H O N E :

Business: (         ) _________________________________

Home:      (        ) _________________________________

 

Check is enclosed # ______________________________

Purchase Order is enclosed # ______________________    

 
       
     

Quantity

 

Unit Price

     
  "COLORS"

____

x $20.00 = $ _____  
  "NUMBERS"

____

x $20.00 = $ _____  
               
 

SAVE MONEY AND BUY BOTH

____

x $35.00 = $ _____  
               
 

  - New Jersey Residents add 7% Sales Tax:

      = $ _____  
 

  - Postage & Handling:

_____

x

$4.50

= $ _____  
               
           

======

 
               
       

Total:

  $_____  
                  
  - Please make check or money order payable to 'Dickson Enterprises Incorporated'.  
  - Please allow four to six weeks for delivery.  
  - If defective, return to Jacqueline Dickson, DEI for replacement within 35 days from date mailed to you.