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Printable Order Form ...

Order Form


Please send me:

    __Making Contact - Sensory Integration & Autism ($89.00 + $6.00 S&H)
    __Autism Perspectives ($89.00 + $6.00 S&H)
    __Seizing The Moment ($89.00 + $6.00 S&H)
    __Autism Insights ($69.00 + $6.00 S&H)
    __All four videotapes ($259 + $16.00 S&H)

Name _____________________________________________________

Shipping Address___________________________________________

City/State/Zip_______________________ ________________ _________________

Home Telephone with AC ____ __________________________________

E-Mail Address:______________________________________

Method of Payment __Mastercard ___Visa ___Check (Make payable to CEPA)

Credit Card # _________________________________

Expiration Date: _______________________________

Cardholder Signature ____________________________________

Mail to:

    Media Publications Division
    Continuing Education Programs of America
    PO Box 52
    Peoria, Illinois 61650
You may fax if using a credit card or PO to: 309-263-8075
Please allow 3-4 weeks for delivery