Print this form to order by mail or Fax
Learning Gear Plus Mail/Fax Order Form
Mail or fax your order to: Learning Gear Plus, Inc. 128 Lunenburg Road West Townsend, MA 01474 FAX: 978-433-3751	Questions about your order? Contact Learning Gear Plus info@learninggearplus.com 978-433-3750
Billing Information (If paying with a credit card, enter the name and address of card holder):	Ship to: (If different from billing address):
Name:	Name:
Company:	Company:
Street:	Street:
City:	City:
State:	State:
Zip Code:	Zip Code:
Phone:	Phone:
E-mail Address:	E-mail Address:

Credit Card Information:
Credit Card Type  (check one):     Visa Mastercard       Discover   American Express
Credit Card Number:	Expiration Date:
Signature of Credit Card Holder:

Item Number	Item Name	Quantity	Unit Price	Total Price
Shipping Fees for UPS or USPS		MA Sales Tax 6.25%
Order Amount: $.01-$30.00 Shipping Fee: $4.99		Shipping
Order Amount: $30.01-$50.00 Shipping Fee: $5.99		GRAND TOTAL
Order Amount: $50.01-$75.00 Shipping Fee: $7.99		Special Instructions:
Order Amount: $75.01-$100.00 Shipping Fee: $9.99
Order Amount: $100.01-$200.00 Shipping Fee: $12.99
Order Amount: $200.01-$400.00 Shipping Fee: $16.99
Please allow 7-10 days for delivery.