Certified Learning Centers, Inc. - Mail/Fax Order Form

To place Your order, Print Out this form, fill it in and
fax to:
301-681-8410 		or mail to:
Certified Learning Centers, Inc.
11309 Classical Lane
Silver Spring, MD 20901
U.S.A.

Name             ___________________________________

Company          ___________________________________

Address          ___________________________________

City, State, Zip ___________________________________

Country          ___________________________________

Phone           (     ) ____________________________

Fax             (     ) ____________________________

E-Mail       _______________________________________
             Confirm Order by Email?   Yes __  No __
Payment: 
AmericanExpress: __   MasterCard: __    Visa: __

Card# _______________________ Exp. Date ________

Name on card ___________________________________

Signature    ___________________________________

                      Qty  Unit Price   Price
____________________  ___  __________  _________

FReader v2.0 CD-ROM          $ 29.95
____________________  ___  __________  _________

Shipping                     $  3.95
____________________  ___   _________  _________

Total
_____________________________________  _________


Thank You for Your order.


Speed Reading Courses  www.readingsoft.com/CLC  Certified Learning Centers, Inc.