Order Form

CAREER PATHWAYS
RESOURCE ORDER FORM
(Print and mail or fax this form)

BILL TO:

Name:
__________________________________

Organization:
__________________________________

Street Address:
__________________________________

City/State:
__________________________________

Zip Code:__________________________

Area Code and Telephone Number:
__________________________________

SEND ORDERS TO:

CAREER SUCCESS
302 W. Front St.
Wayland, Iowa 52654

Phone: 319-256-7206
FAX: 319-256-6397

SHIP TO: (If different from BILL TO)

Organization:
__________________________________

Street Address:
__________________________________

City/State:
__________________________________

Zip Code:__________________________

RESOURCE ORDERED:

Quantity	Description	Unit Price	Total
	Career Pathways-Video	10.00
	Career Pathways Brochure	.75
	Career Pathways Student Guide/Parent Handbook	2.00
	Career Pathways Resource Guide	45.00
	Career Pathways-Set of 6 color icons on paper	25.00
	Career Pathways-Set of 6 color icons on 3.5HD disk, EPS only, specify Mac or PC	10.00
	Career Pathways-Set of (2) Waterfall Disks PC	15.00

Orders from outside Iowa will be billed for shipping and handling. TOTAL ________