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Child Sexual Abuse Prevention
Education versus Prevention
Empowering Children
Start Talking
Ask answer and listen
Keep Talking
Thank You
Education About Abuse & Safety
What to talk about
Educational Materials
Lets Talk Book Information
Ordering Information
Getting Help
When you suspect abuse
Mission Statement
About Dr Stauffer and Hope
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To place an order by mail,
print this form and send it to:
Hope for Families, Inc.,
P.O. Box 238,
Hatfield, PA 19440
If paying by check or money order,
make it payable to Hope for Families. |
Name:_________________________________
Agency Name: ______________________________
Address: ____________________________
____________________________________
Phone: _______________________________
E-Mail:___________________________________
(Please see descriptions of Books in the Online Catalog)
Quantity of LEt's Talk... Body Safety for Young Children books: ______________
Total price of young children'sbooks at $10 per book: ______________
Quantity of Let's Talk.. Body Safety (elementary)books: _______________
Total price of elementary Body Safety books(@$15 per book):______________
Quantity of Coping and Safety Skills workbooks:___________________
Total price of workbooks(@$8 per book):_____________________
Quantity of 5-pack Safety Skill activity books:__________________
Total Price of 5-pack activity books (@$10):______________________
Quantity of 100-pack Safety Skill activity books:______________________
Total prise of 100-pack activity books (@ $150):_________________________
Total Price of Books: _______________
(PA ONLY)Sales tax: ______________
( 6% tax for PA residents;
7% for Phila & Pitts residents)
Shipping & Handling: _____________
($7 for up $20, $12 for $21-120, over $120 add 10%; add $10 extra for international delivery up to $100, over $100 add an additional 10%)
Total price of order: ______________
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| FOR CREDIT CARD ORDERS, COMPLETE THE FOLLOWING INFORMATION |
Circle card type:
MASTERCARD VISA AMERICAN EXPRESS |
Name on Card:______________________________________
Address of Account Holder (if different than above):
____________________________________________
____________________________________________
Account Number _____________________________
Expiration Date ______________
Authorizing Signature __________________________________
By signing, you are giving permission for this amount to be charged to your credit card. |
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