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2015-2016 MEDIA IN EDUCATION ORDER FORM
Delivery Information:
School Name: Teacher Name:
School Address:City:Zip Code:
Phone number:Fax:E-mail address:
Grade:Subject:Number of students:
Delivery Instructions:
Start date:
Stop date:
Democrat and Chronicle:
# of copies per day:_____________
Delivery days:
M_____ T_____ W_____ TH_____ F_____
USA Today: # of copies per day:_____________
Delivery days:
M_____ T_____ W_____ TH_____ F_____
Vacation calendar:
Please X out holidays and vacation days you DO NOT want the papers delivered. Please note - newspapers will be delivered on days not “X” out.
JULY2015
M T W
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F
AUGUST2015
M T W
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F
SEPTEMBER2015
M T W
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F
OCTOBER2015
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F
NOVEMBER2015
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T
F
DECEMBER2015
M T W
T
F
JANUARY2016
M T W
T
F
FEBRUARY2016
M T W
T
F
MARCH2016
M T W
T
F
APRIL2016
M T W
T
F
MAY2016
M T W
T
F
JUNE2016
MTW T F
JULY2016
M T W
T
F
AUGUST2016
M T W
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F
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Democrat and Chronicle
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1-29 weekly copies $0.50 per copy
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1
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29
30 or more copies per week
$0.35 per copy
30 or more copies per week
$0.55 per copy
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Democrat and Chronicle
c /o MIE
55 Exchange Blvd.
Rochester, NY 14614
USA Today
1-29 weekly copies $0.75 per copy
E-edition licenses
FREE of charge via GME just visit https://gannettmediaeducation.gannett.com
Summary of 2015/2016 MIE order:
Number of copies per day __________ x total number of days delivered ____________ x cost per paper _________ = total cost $__________________
Billing Information:
Purchase order number:
Bill To:Address: City:Zip Code:
Master Card
VISA
DISCOVER
Attention: AMEX
Name on card:
Key Contact Information:
Address:
City:
Any new orders, additions or deletions must be received
5 business days prior to change or start.
Toll Free: 1-800-767-7539 ext. 2629 Fax: 585-258-2241
State:
Account #:
Signature:Exp. Date:
Zip:
Ordering, Billing and/or Delivery issues: 585-258-2629
Email: [email protected]
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