Order Form
Please print this page and mail with payment
Knowledge by Design, Inc., 5907 N. Kent Avenue, Whitefish Bay, WI 53217

1. Shipping Information (Please print clearly)

Name ______________________________________________________________
School/Agency _______________________________________________________
Street Address _______________________________________________________
City ______________________________ State _________ Zip Code ___________
Daytime Phone (______) ___________________________


2. Items Ordered (All prices listed in U.S. funds)

Title	Price	Quantity	Total
Handbook of Special Education Technology Research and Practice	$119.00	______	$
Shipping and Handling (per copy)	$12.00	______	$
Sales Tax (WI residents only) (per copy)	$4.98	______	$
Total			$

3. Payment (Payment must accompany order. We are unable to accept purchase orders.)

___ Check: Make checks payable to Knowledge by Design, Inc.
___ Credit Card: Mastercard or VISA (circle one)
Account Number ___________________________ Exp. Date _______
Name as it appears on credit card ______________________________
Signature _________________________________________________


Questions? Please give us a call at 414/962-0120.